Most people would prefer to die at home. But there could be one benefit to dying in a hospital that people may not realize: a free autopsy.
Yes, that's right. A hospital that may charge tens of thousands of dollars for heart surgery generally won't charge the family a penny to perform an autopsy to figure out if it was heart disease or something else that caused a patient's death. (Hospitals that don't do autopsies may arrange to have one done elsewhere.)
There are good reasons for hospitals to absorb the cost of autopsies. The biggest one is education.
Up to 40 percent of the time, what the hospital thought was the cause of death turns out to have been incorrect. Autopsies also provide key information about how a disease progresses and whether treatments are effective or not. In one study at Pennsylvania State University, autopsies revealed "findings that would have changed" treatment in about 1 of 4 cases.
Still, hospital autopsies aren't as common as they used to be. Until 1970, hospitals had to autopsy at least 20 percent of their patients or lose their accreditation from an independent nonprofit group. Then the requirement was scrapped, and hospitals now perform autopsies on just an estimated 5 percent of patients. "Forty percent of hospitals do zero autopsies now," says Dr. Elizabeth Burton, deputy director of the autopsy service at the Johns Hopkins Hospital in Baltimore. At academic medical centers and big hospitals the rate might be 15 to 20 percent, she says.
For families, of course, an autopsy can help answer nagging questions about the cause of death and provide vital information about diseases with genetic underpinnings, such as cancer.
That's where dying at home becomes a factor. Hospitals will often do an autopsy on a patient who dies at home within a designated time period — sometimes a year or longer.
But the family of someone who just dies a natural death at home and hadn't been a hospital patient recently may have to pony up the $3,500 to $6,000 autopsy fee on their own if they want one performed.
Sometimes hospitals do it for a fee, or there are private outfits that also offer autopsy services. Despite sometimes cheezy names like 1-800-AUTOPSY, these private companies are "definitely OK," says Burton.
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