Albertson Timothy, Tharratt R Steven, Marquardt Kathy, Alsop Judith, Ninomiya John, Foulke Garrett
California Poison Control System, Sacramento Division, Sacramento, CA, USA.
J Med Toxicol. 2008 Sep;4(3):151-6. doi: 10.1007/BF03161193.
Poison Control Centers (PCCs) have been shown to reduce health expenditures by reducing emergency department and clinic visits. The effect or association of PCC call frequency on acute hospitalization rates for poisonings has not been studied extensively.
All nonfederal hospital discharges for acute poisoning principal diagnosis codes (960-979, 980-989, 9956X, 3030, and 005) in California between October 1999 and June 2002 were examined. Approximately 3.3% of the discharges had county/hospital information suppressed in the public-use database because of confidentiality criteria and were excluded from the analysis. U.S. Census Bureau population estimates for appropriate years by counties were also obtained. The 58 California counties were condensed to 48 counties and 3 "small-county" geographic groupings. Exposure calls by counties/groupings to the California Poison Control System(CPCS) for the same period were tabulated.
In California, rates of hospital discharges for poisoning averaged 0.54/1000 person years with a range of 0.25/1000 person years (Central Counties) to 1.53/1000 person years (Del Norte County). Poison call rates averaged 8.5/1000 person years with a range of 4.9/1000 person years (Los Angeles County) to 19.6/1000 person years (Napa County). Poisoning discharges per 1000 person years positively correlated with PCC calls per 1000 person years (Spearman correlation 0.41, p = 0.0003). The average hospital length of stay (LOS) did not correlate with PCC call frequency or poisoning discharges per 1000 person years.
The CPCS call frequency or county penetrance was not correlated with a reduction in the number of hospitalizations for poisoning nor was it associated with reduced average LOS in this study. Further study is needed to understand the etiology of the large differences in county rates of poisoning hospitalization and average LOS.
中毒控制中心(PCCs)已被证明可通过减少急诊科和门诊就诊次数来降低医疗费用。PCC呼叫频率对中毒急性住院率的影响或关联尚未得到广泛研究。
对1999年10月至2002年6月期间加利福尼亚州所有以急性中毒为主诊断编码(960 - 979、980 - 989、9956X、3030和005)的非联邦医院出院病例进行了检查。由于保密标准,约3.3%的出院病例在公共使用数据库中县/医院信息被屏蔽,因此被排除在分析之外。还获取了美国人口普查局按县划分的相应年份的人口估计数。加利福尼亚州的58个县被合并为48个县和3个“小县”地理分组。统计了同期各县/分组向加利福尼亚中毒控制系统(CPCS)的暴露呼叫次数。
在加利福尼亚州,中毒的医院出院率平均为0.54/1000人年,范围从0.25/1000人年(中部各县)到1.53/1000人年(德尔诺特县)。中毒呼叫率平均为8.5/1000人年,范围从4.9/1000人年(洛杉矶县)到19.6/1000人年(纳帕县)。每1000人年的中毒出院人数与每1000人年的PCC呼叫次数呈正相关(斯皮尔曼相关性为0.41,p = 0.0003)。平均住院时间(LOS)与PCC呼叫频率或每1000人年的中毒出院人数无关。
在本研究中,CPCS呼叫频率或县渗透率与中毒住院人数的减少无关,也与平均住院时间的缩短无关。需要进一步研究以了解各县中毒住院率和平均住院时间存在巨大差异的病因。