Kusum D Jashnani, Jaya R Deshpande, Gayathri P Amonkar
Department of Pathology, T.N. Medical College & BYL Nair Ch Hospital, Mumbai.
Indian J Pathol Microbiol. 2006 Apr;49(2):188-92.
Medical audit is essential in assessing the efficacy of health care delivery system. Though autopsy services are generally looked upon indifferently and with sceptism by the clinicians, it can form an important part of the medical audit system. The aims of this study were to audit autopsies of deaths within 24 hours of hospital admission by: 1) Comparing premortem and postmortem diagnosis; 2) Comparing postmortem gross diagnosis with postmortem histopathologic diagnosis; 3) Whether deaths could be certified based on clinical judgement and autopsies avoided. The study sample was 99 autopsies. In 45% autopsies, clinical impression did not match the final cause of death. In 14.2% autopsies, final cause of death could have been given by the clinician based on his clinical judgement. In 54.5% autopsies, there was agreement between premortem and postmortem diagnosis. In 67.6% autopsies, gross findings matched with the histopathologic findings.
医疗审计对于评估医疗服务提供系统的有效性至关重要。尽管临床医生通常对尸检服务漠不关心且持怀疑态度，但它可以成为医疗审计系统的重要组成部分。本研究的目的是通过以下方式对入院后24小时内死亡的尸检进行审计：1）比较生前诊断和死后诊断；2）比较死后大体诊断和死后组织病理学诊断；3）是否可以根据临床判断开具死亡证明并避免尸检。研究样本为99例尸检。在45%的尸检中，临床印象与最终死因不相符。在14.2%的尸检中，临床医生根据其临床判断本可给出最终死因。在54.5%的尸检中，生前诊断和死后诊断一致。在67.6%的尸检中，大体检查结果与组织病理学检查结果相符。
