Beyond Cause of Death: Translating Medico-Legal Autopsy Evidence into Risk Mitigation, Organizational Learning, and Institutional Adoption

Background/Objectives: Although medico-legal autopsy remains an important source of postmortem evidence for clarifying causes and circumstances of death, identifying diagnostic discrepancies, and evaluating adverse clinical outcomes, its relevance may extend well beyond individual case resolution. Evidence generated after death can contribute to healthcare risk management, organizational learning, and institutional decision-making, yet the mechanisms through which these benefits acquire broader system value remain insufficiently understood. This study therefore examined relationships among medico-legal risk mitigation, financial risk mitigation, organizational learning capability, perceived system value, and institutional adoption intention. Methods: A cross-sectional survey of 1035 professionals working in healthcare, forensic medicine, pathology, legal, and administrative settings in Serbia was analyzed using exploratory and confirmatory factor analyses, structural equation modeling, and bootstrap mediation analysis. Results: Greater medico-legal risk mitigation was associated with both financial risk mitigation and perceived system value, whereas financial risk mitigation and organizational learning capability independently contributed to perceived system value. In turn, perceived system value showed the strongest direct relationship with institutional adoption intention. Mediation analyses further identified an indirect learning pathway and a sequential mechanism linking medico-legal risk mitigation with institutional adoption through financial risk mitigation and perceived system value. Conclusions: These findings position postmortem evidence as a potential source of diagnostic and organizational intelligence rather than solely as the endpoint of retrospective investigation. Its broader institutional relevance depends on the extent to which evidence generated through autopsy can be translated into risk mitigation, organizational learning, and recognized system value that supports systematic integration into healthcare practice.