Possibilities of comparing clinical and postmortem diagnoses

Abstract

The current attitude (qualification, education, interest) of doctors towards the performance of tasks with regard to the requirements and measures of international classification of diseases, injuries and causes of death are reflected in death certificates with statements of cause of death, which are the foundation for primary (national and international) statistics on morbidity and causes of death, as well as for planning for medical personnel in individual fields of medicine. On the basis of collected death certificates with statements of cause of death and schedules of diseases if they were enclosed, we compared the clinical with the postmortem diagnoses from 444 autopsy reports, in which we established 49% complete agreement of clinical with postmortem diagnoses and 13% complete disagreement. Although doctors also have the legal obligation and responsibility to fill out these reports professionally and correctly, it is different in practice. Death certificates are often so incomplete that they do not fulfil even the minimal requirements for identification of the deceased. In addition to inconsistencies in filling out death certificates, i.e. primary cause of death, condition which led to death and immediate cause of death, another cause of disparity between clinical and postmortem diagnoses is, in our opinion, the fact that clinical diagnoses are functionally oriented, while postmortems are pathomorphologically oriented, which could also be a reason for the lower percentage of correspondence between clinical and postmortem diagnoses and unrealistic analyses of national pathology. Autopsies remain an important factor in the treatment and analysis of pathology in Slovenia, on the basis of which it is possible to plan and direct health care activities and their personnel and material needs. At the same time autopsies are a form of quality control for the entire field of health care activities.