[Decline in hospital autopsies].

BACKGROUND: According to the new autopsy regulation from April 2004 the next to kin must be informed of an autopsy and the right to deny consent. The present study aims at documenting the impact of this regulation on the number of autopsies performed and to determine whether regular reminders and changed autopsy routines could reduce the time needed to complete autopsy reports.

MATERIAL AND METHODS: The following information was gathered; the number of autopsies before and after implementation of the regulation, the number of next to kin who had been informed and the number that had denied consent. The consequence of monthly reminders to the pathologists for the time needed to complete the autopsy report was examined for the years 2000 to 2004. The autopsy routine was altered for six weeks in 2005; the doctors performed autopsies for two successive weeks instead of one. The time to complete the report in this period was compared with that of the same period the year before. The chi-squared test, the Mann-Whitney test and the Kruskal-Wallis test H test were used.

RESULTS: After the autopsy regulation was introduced the number of autopsies/year decreased from 432 (39%) to 332 (31%) of all who had died in the hospital (p < 0.001). For 211 (20%) of the deaths, the next to kin had not been informed. The number who denied consent increased from 258 (23%) to 373 (35%). Monthly reminders reduced the median time for completing the autopsy report from 58 to 38 days (p < 0.001). Altering the autopsy routine reduced the median time needed to complete the report from 46 days the year before to 14 days after the changed routine (p < 0.001).

INTERPRETATION: Better information to next to kin will probably increase the number of autopsies. The time needed for completing the autopsy report can be reduced by simple means.