[The importance of autopsy for quality assurance in medical care]

For all persons who died in the city of Dresden and 7 surrounding counties from 1967 to 1978, documents relating to the clinical and pathologic diagnosis were examined and findings compared. The study covered nearly two thirds of all deaths which occurred in the district of Dresden during this time period. The autopsy rate overall was found to be 22.8%. In 57.3% the clinical diagnoses were found to have been correct, in 19.7% they corresponded in part, but in 23% there was no concordance whatsoever between the clinical and autopsy diagnoses. The influence of age, place of death and disease group on the agreement between clinical and underlying pathoanatomic diagnosis was also examined. The analysis highlighted the degree to which death statistics based on the death certificate are misleading. In up to 28.8% of cases there were formal errors in the underlying disease diagnosis listed by the certifying physician on the death certificate. The value of regular comparison between the diagnoses, and its usefulness for training and continuing medical education are emphasized. The results of the study underline the importance of making available more prospectors in the district of Dresden to meet the expanding tasks of the clinically active pathologist in autopsy and biopsy diagnostic efforts.