Zaloshnja Eduard, Miller Ted, Jones Paul, Litovitz Toby, Coben Jeffrey, Steiner Claudia, Sheppard Monique
Pacific Institute for Research and Evaluation, 11710 Beltsville Dr, Suite 125, Calverton, MD 20705, USA.
Pediatrics. 2006 Nov;118(5):2094-100. doi: 10.1542/peds.2006-1585.
This study tested the hypothesis that underutilization of poison control centers is associated with increased rates of hospitalizations attributable to poisonings in rural areas.
To measure the potential impact of poison control centers on hospitalization rates in rural areas among people who visit emergency departments because of poisoning, we estimated the reduction in hospitalization rates associated with increased rates of calls to centers. We used the 2003 State Inpatient Database and State Emergency Department Database from the Healthcare Cost and Utilization Project to calculate the numbers of emergency department visits and hospitalizations for each county in the 12 states analyzed. We used Toxic Exposure Surveillance System data from the American Association of Poison Control Centers to calculate the number of human exposure calls per capita according to county.
In rural counties, a 1% higher poison control center human poison exposure call rate was associated with a 0.19% lower hospitalization rate among people who visited emergency departments because of poisoning. If the observed association is causative, then 43.3 calls would prevent 1 hospital admission, yielding 7321 dollars in net cost savings and a return on investment of 5.9:1 (from the health care system perspective).
Our results establish the existence of the hypothesized association between rural poison control center utilization rates and hospitalization rates among emergency department-treated poisoning patients.
本研究检验了以下假设，即农村地区中毒控制中心利用不足与因中毒导致的住院率上升相关。
为衡量中毒控制中心对因中毒就诊于急诊科的农村地区人群住院率的潜在影响，我们估计了与呼叫中毒控制中心次数增加相关的住院率降低情况。我们使用了医疗保健成本与利用项目2003年的州住院数据库和州急诊科数据库，来计算所分析的12个州中每个县的急诊科就诊次数和住院次数。我们使用了美国中毒控制中心协会的毒物暴露监测系统数据，按县计算人均人类暴露呼叫次数。
在农村县，中毒控制中心人均人类中毒暴露呼叫率每提高1%，因中毒就诊于急诊科的人群住院率就降低0.19%。如果观察到的关联是因果关系，那么43.3次呼叫可避免1例住院，净成本节省7321美元，投资回报率为5.9:1（从医疗保健系统角度来看）。
我们的结果证实了农村中毒控制中心利用率与急诊科治疗的中毒患者住院率之间存在假设的关联。
