Rates of postmortem examination in Austria: the effect of distance between location of death and site of examination.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
D001317:Austria; D001344:Autopsy / Q000191:economics / Q000706:statistics & numerical data*; D002423:Cause of Death; D003365:Costs and Cost Analysis; D004777:Environment; D006801:Humans; D016015:Logistic Models; D012680:Sensitivity and Specificity