Die modernen Aufgaben der Obduktion in der Kontrolle des öffentlichen Gesundheitswesens

Summary

Due to a liberal law regarding the performance of autopsies in Austria there is a high rate of postmortems in Vienna (about 50% of all deaths). Supported by a grant from the Austrian Government the autopsy records of all hospitals in Vienna have been registered by EDV using a clear-textsystem. The autopsy records of the Institute of Forensic Medicine have been included in this study. These conditions made it possible to compare critically the official Austrian mortality statistic against the autopsyfindings. Several examples of neoplastic diseases and cardiovascular diseases with different discrepancies between the two statistics are given in this paper. The following conclusions can be drawn from this critical comparison:

• 1. A control and correction of official mortality statistics is possible by a centralized documentation of autopsy records and a high postmortem rate.

• 2. Uncontrolled mortality statistics based on monocausality due to WHO directions show severe deviations from the real situation, even in important groups of diseases.

• 3. The evaluation of multicausality of death gives a better registration of the actual morbidity within a population.

• 4. The efficiency of public health provisions, especially in the field of prevention and prenotion of diseases, can be evaluated much better by using the more detailed registration of oncologic data by postmortems. The introduction and the execution of such provisions can be controlled more accurately and sufficiently.