Fewer Hospital Autopsies Mean More Undiscovered Medical Errors: Part 1

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For decades now, there has been a downward trend in the number of routine autopsies that are performed by hospitals. The troubling results of that trend are that diagnostic errors, wrongful death and medical malpractice can go unreported because the errors are not found, and the mistakes end up being literally buried with the deceased. A recent investigative series by ProPublica looked into this issue and the implications it raises for people in Ohio and around the country.

More than 50 years ago autopsies were routinely performed on approximately half of all hospital patients who died. Prior to 1971, The Joint Commission, the health-care facility accrediting agency, mandated autopsy rates of 20 and 25 percent for community hospitals and teaching facilities, respectively.

But that requirement has since been dropped. Without that requirement, most hospitals across the country are conducting autopsies at increasingly lower rates. In fact, many new hospitals are being built without places to conduct autopsies on site. And most insurance companies nowadays do not pay for autopsies (the average cost of an autopsy is around $1,300).

The use of modern diagnostic equipment like MRIs and CT scans also contributes to fewer autopsies being performed. Those tools have given doctors an increased confidence about identifying ailments in patients while they are still alive. Therefore, doctors have steadily moved away from ordering autopsies after patients die.

But autopsies are still crucial medical tools that are used to better diagnose and treat patients and evaluate doctor performance because doctors still make mistakes. They may never find out whether they made the correct diagnosis or used the best treatment or therapy if they do not find out through an autopsy how a patient died, which means they doctors will continue to make the same mistakes.

The next post will continue to discuss this issue.

Source: ProPublica, “Without Autopsies, Hospitals Bury Their Mistakes,” Marshall Allen, Dec. 15, 2011

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