[Documentation of the diagnostic quality of hospitals: evaluation of autopsy reports]

Multiple factors have affected the decline in autopsy rates. Discrepancies between clinical diagnoses and findings at autopsy are frequently used as an argument for a high autopsy rate. However, the quality of the diagnosis is independent of the autopsy rate. A long-term study covering the years 1972-2002 in the University Hospital Zurich has documented a significant reduction of diagnostic errors in internal medicine. Major diagnostic errors (class 1) declined from 16% (1972), to 9% (1982), to 7% (1992) to 2% (2002). The main reason is the availability of new diagnostic procedures. In 2010 the analysis of class 1 diagnostic errors throughout the hospital documented class 1 discrepancies in only 1%. This low number of diagnostic errors has been published in the annual quality report of the University Hospital Zurich. The documentation of this improvement in the quality report of the hospital provides the opportunity to convince clinicians, health politicians and the hospital administration to support autopsies in teaching as well as non-teaching hospitals.