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Increasing autopsy rates at a public hospital
1Department of Medicine, Mount Sinai Services, Queens Hospital Center, Jamaica, NY 11432, USA.
Journal of General Internal Medicine
|May 1, 1997
Summary
An intervention to boost autopsy rates in hospitals temporarily increased them from 7.5% to 16.8%. However, the effect vanished post-intervention, with physician requests and family refusals being key barriers.
Area of Science:
- Medical research
- Clinical pathology
- Hospital administration
Background:
- Autopsies are crucial for medical understanding but face declining rates in US hospitals.
- Identifying barriers to obtaining autopsy consent is essential for improving rates.
Purpose of the Study:
- To implement and evaluate an intervention aimed at increasing autopsy rates.
- To determine the obstacles encountered when seeking permission for autopsies.
Main Methods:
- A 6-month intervention was conducted on the medical service of an urban teaching hospital.
- Autopsy rates were tracked before, during, and after the intervention.
- Physician requests and family refusal rates were analyzed for cases where consent was not obtained.
Main Results:
- The intervention significantly increased the autopsy rate from 7.5% (previous 2 years) to 16.8% during the 6-month period.
- This positive effect on autopsy rates diminished after the intervention concluded.
- Physicians did not request permission in 31% of cases, and families refused in 69% of cases where permission was not obtained.
Conclusions:
- While interventions can temporarily raise autopsy rates, sustained improvement requires addressing systemic issues.
- Physician-related factors (failure to request) and family decisions (refusal) are significant barriers to autopsy consent.
- Further strategies are needed to overcome these obstacles and improve autopsy utilization in clinical settings.