The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, USA.
J Community Health. 2010 Dec;35(6):572-8. doi: 10.1007/s10900-010-9243-8.
Poison control centers have been shown to be a cost-effective alternative to healthcare visits for poisoning exposures, yet emergency departments (ED) and urgent care centers (UCC) continue to be frequently accessed for poisoning exposures in young children. We sought to identify predictors of young children who obtain healthcare for a nontoxic poisoning exposure. Poisoning exposure cases for children ≤5 years old who sought ED, UCC, or clinic care between 2001 and 2005 from an urban regional pediatric hospital system were identified from poisoning ICD-9 codes in the hospital administrative data and from a poisoning designation in the National Electronic Injury Surveillance System (NEISS) data. Cases (n = 2,494) were reviewed and categorized as either toxic or nontoxic. Toxic exposures were those with more than minimal potential for clinical effects. Most cases were between 1 and 2 years old, male, White, enrolled in Medicaid, sought ED care, had no referring physician, and brought to the facility by a parent/guardian. Logistic regression analysis revealed that the odds of seeking healthcare for a nontoxic poisoning exposure were significantly greater if the child was African American, enrolled in Medicaid, had a non-medication related poisoning, and was brought to the healthcare site by a parent/guardian. Healthcare costs and unnecessary use of healthcare resources for nontoxic poisoning exposures could be reduced by educating parents and providers of children at high risk for inappropriate healthcare visits for nontoxic poisonings to initially contact the poison control center (1-800-222-1222).
中毒控制中心已被证明是一种具有成本效益的替代医疗保健服务,可用于治疗中毒暴露,但在幼儿中毒暴露的情况下,急诊部门 (ED) 和紧急护理中心 (UCC) 仍经常被访问。我们旨在确定哪些因素可预测幼儿因非毒性中毒暴露而获得医疗保健。从城市地区儿科医院系统的医院管理数据中的中毒 ICD-9 代码和国家电子伤害监测系统 (NEISS) 数据中的中毒指定中确定了 2001 年至 2005 年期间,5 岁以下儿童因 ED、UCC 或诊所就诊的非毒性中毒暴露病例。对病例 (n = 2,494) 进行了审查和分类,分为有毒或无毒。有毒暴露是指具有临床影响的潜在可能性较大的暴露。大多数病例为 1 至 2 岁,男性,白人,参加医疗补助,寻求 ED 护理,没有转诊医生,由父母/监护人带到医疗机构。Logistic 回归分析显示,如果儿童是非裔美国人,参加医疗补助,有非药物相关的中毒,并且由父母/监护人带到医疗场所,那么寻求非毒性中毒暴露的医疗保健的可能性就会大大增加。通过教育父母和有高风险的儿童的医疗保健提供者,他们可能会因不适当的医疗保健就诊而接触非毒性中毒,最初联系中毒控制中心 (1-800-222-1222),可以降低非毒性中毒暴露的医疗保健费用和不必要的医疗保健资源使用。