Rates of postmortem examination in Austria: The effect of distance between location of death and site of examination

• Published in: Journal of clinical epidemiology Vol. 56; no. 9; pp. 891 - 895
• Main Authors: Waldhoer, T, Berzlanovich, A, Vutuc, C, Haidinger, G
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2003; Elsevier; Elsevier Limited
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Austria; Autopsies; Autopsy - economics; Autopsy - statistics & numerical data; Biological and medical sciences; Cause of Death; Clinical death. Palliative care. Organ gift and preservation; Costs and Cost Analysis; Disease; Divorce; Environment; Epidemiology; Health risks; Hospitals; Humans; Location of death; Logistic Models; Medical sciences; Mortality patterns; Postmortem examination; Sensitivity and Specificity; Site of examination; Spatial distribution; Austria; Europe; Postmortem examination; Location of death; Site of examination; Human; Autopsy; Postmortem; Forensic aspect; Epidemiology; Public health
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/S0895-4356(03)00076-3

Despite the importance of autopsies for diagnosing disease and determining cause of death, autopsy rates are decreasing in many countries. Furthermore, autopsy rates are often not distributed randomly between different regions within countries. In this study we analyzed an apparent nonrandom spatial distribution of autopsy rates in Austria for the period 1991–2000. We tested the new hypothesis that the rate of autopsies performed on people who die at home depends on the distance from the residence to the hospital or forensic institute where autopsies are performed.
Data were extracted from the official mortality records for the years 1991–2000. Only persons who deceased in private residences were included. A logistic regression model was used.
Even controlling for variability in sex, age, date of death, and family status, the effect of distance significantly implied lower autopsy rates in the alpine parts of Austria.
This effect of distance may lead to artificially nonrandom mortality patterns in disease maps. As a consequence, the possibility of hypothesizing incorrect health risks to explain nonrandom mortality patterns increases.