Die klinische Autopsie aus der Sicht des Gesundheitspolitikers

Abstract

The autopsy--as the lesson of death--should be an integrated constituent of our affairs of health services. Beside its task for teaching and training as well as the post-autopsy follow-up with families, the autopsy plays a vital role for the quality assessment and the health statistics as the basis for the health care policy. By the introduction of the DRG system (diagnosis related groups), as a lump sum based charging system of inpatients regardless of diagnostic procedures and therapy and the equalization of costs for similar services calculations, should also include the costs of autopsy. The quality assurance is garanteed and independently attained by the autopsy service. Moreover, this is the only way to overcome the danger of abolishing essential diagnostic and therapeutic procedures because of economic pressure. However, the impact of the autopsy service is widely neglected. Therefore, widespread information about this matter in the medical profession, in the general public and in politics is mandatory.

Who Is at Risk for Diagnostic Discrepancies? Comparison of Pre- and Postmortal Diagnoses in 1800 Patients of 3 Medical Decades in East and West Berlin

“…As already discussed previously by both clinicians and pathologists [2], [19], [34]–[37] there is a dual and uncontentious role for autopsies as a benchmark and to unravel diagnostic discrepancies, especially in times where economization and cost-effectiveness are on the top of the agenda [4], [38], [39]. The clinical non-forensic autopsy provides an economical and practical knowledge source that directly aids the physician [18, study initiated by the U.S. Department of Health and Human Services 2002], helps to describe novel diseases and is indispensable in physician teaching and additionally adds important epidemiological data to the mortality statistics [40] which often serve as a basis for decisions in health policy with far-reaching consequences.…”