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Hospital autopsies are on the verge of extinction, study finds

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h3236 (Published 16 June 2015) Cite this as: BMJ 2015;350:h3236
  1. Jacqui Wise
  1. 1London

Postmortem examinations are now carried out in just over half of 1% of all UK hospital deaths, and the procedure has disappeared altogether in a quarter of NHS trusts, a survey published in the Journal of Clinical Pathology has shown.

The researchers submitted freedom of information requests to 160 NHS acute trusts in England, 14 NHS health boards in Scotland and seven in Wales, and five social care trusts in Northern Ireland. The response rate was 99%.1

The average autopsy rate was 0.69% of all hospital deaths, but this varied across the United Kingdom. The hospital autopsy rate of 2.13% in Scotland was significantly higher than in other countries. The lowest rate was in Northern Ireland, at 0.46%. In England the rate was 0.51%, and in Wales it was 0.65%.

No autopsies at all were carried out in 23% of trusts. In most trusts (86%) the postmortem rate was under 1%. In only 1.8% of specialist trusts did rates exceed 5%—the figure previously published for non-teaching hospitals.

Hospital autopsy rates have been falling in the UK and worldwide for more than half a century and account for a small minority of all autopsies in the UK at around 1.2%.

“The decline in hospital autopsy has continued relentlessly and, for better or worse, the practice is on the verge of extinction,” the authors concluded. They said that few healthcare professionals or politicians were aware of this trend and that the implications were not yet fully understood.

“With such low numbers, questions must be asked regarding the effect such decline has on quality assurance, public health, misdiagnosis (a key contributor to avoidable harms), audit, and the teaching of both medical students and trainee pathologists,” they wrote.

Notes

Cite this as: BMJ 2015;350:h3236

References

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