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The declining autopsy rate and clinicians' attitudes
M B Loughrey1, W G McCluggage, P G Toner
1Department of Pathology, Royal Victoria Hospital, Belfast.
The Ulster Medical Journal
|February 24, 2001
Summary
The overall autopsy rate at Royal Victoria Hospital declined significantly from 30.4% in 1990 to 18.4% in 1999, primarily due to decreasing hospital autopsy rates. Clinicians cited consent difficulties and advanced diagnostics as key reasons for this trend.
Area of Science:
- Medical Pathology
- Clinical Diagnostics
- Healthcare Trends
Background:
- Autopsy rates are declining globally.
- This study examines autopsy trends at Royal Victoria Hospital, Belfast.
- Data spans from 1990 to 1999, including comparative historical data.
Purpose of the Study:
- To determine overall and differential autopsy rates.
- To analyze trends in autopsy rates over a decade.
- To identify clinician-perceived reasons for declining autopsy rates.
Main Methods:
- Retrospective analysis of autopsy records.
- Comparison of autopsy rates across different years (1990-1999).
- Questionnaire survey of hospital clinicians regarding reasons for decline.
Main Results:
- Overall autopsy rate dropped from 30.4% (1990) to 18.4% (1999).
- Hospital autopsy rate decreased from 21.6% (1990) to 7.9% (1999).
- Coroner's autopsy rate remained stable around 11%; declines were noted across major directorates, especially medicine, surgery, and intensive care.
Conclusions:
- The decline in autopsy rates mirrors global trends, despite the autopsy's proven clinical value.
- Difficulty in obtaining consent and advancements in diagnostic technology are primary perceived reasons for the decline.
- Active engagement in medical education and emphasizing the autopsy's role in teaching, research, and audit are crucial for its preservation.