National Capital Poison Center, Washington, DC 20016, USA.
Clin Toxicol (Phila). 2010 Jun;48(5):449-57. doi: 10.3109/15563651003757947.
High poison center utilization has been associated with decreased emergency department usage and hospitalization rates. However, utilization requires awareness of the poison center. Penetrance, defined as the number of human poison exposures reported to a poison center per 1,000 population, has been used as a marker of poison center awareness.
To identify factors that influence poison center penetrance to optimize the life- and cost-saving benefits of poison control centers.
Human poison exposures that were reported to the National Poison Data System in 2001 were analyzed to identify and rank factors affecting poison center penetrance.
Overall penetrance correlated with pediatric penetrance (R(2) = 0.75, p < 0.01). As pediatric penetrance increased, there was a significant decline in the percent of children reported to a poison center that were already in or en route to a healthcare facility at the time of the call to the poison center (R(2) = 0.41, p < 0.01). Larger poison center service populations were associated with lower penetrance (R(2) = 0.23, p < 0.01). Inverse predictors of penetrance included inability to speak English well, Black/African American race, and distance from the poison center (multiple regression). Positive predictors included the percentage of the population younger than 5 years, the percentage of the adult population with a bachelor's degree, poison center certification, poison center educator FTEs (full time equivalents), Asian population percentage, and population density.
The inverse correlation between pediatric penetrance and healthcare facility utilization supports prior observations of excessive healthcare utilization when a poison center is not called. Since race, language and distance are barriers to poison center utilization, and since healthcare utilization increases when poison center penetrance declines, low penetrance suggests a lack of awareness of the poison center rather than a low incidence of poisonings.
Strategies to raise penetrance should be informed by an understanding of the barriers to utilization - language, Black/African American race, distance from the poison center, poverty, and lower education levels.
高毒中心利用率与急诊就诊率和住院率下降有关。然而，利用率需要对毒理中心有一定了解。渗透率，定义为每千人口向毒理中心报告的人类毒物暴露数量，一直被用作毒理中心知晓度的指标。
确定影响毒理中心渗透率的因素，以优化毒物控制中心的生命和成本节约效益。
对 2001 年向国家毒物数据系统报告的人类毒物暴露情况进行分析，以确定并排名影响毒理中心渗透率的因素。
总体渗透率与儿科渗透率相关（R²=0.75，p<0.01）。随着儿科渗透率的增加，向毒理中心报告的儿童中，在致电毒理中心时已经在或正在前往医疗机构的比例显著下降（R²=0.41，p<0.01）。毒理中心服务人群越大，渗透率越低（R²=0.23，p<0.01）。渗透率的负预测因子包括英语水平差、黑种人/非裔美国人种族和距离毒理中心的远近（多元回归）。渗透率的正预测因子包括 5 岁以下人口比例、拥有学士学位的成年人口比例、毒理中心认证、毒理中心教育工作者 FTE（全职当量）、亚洲人口比例和人口密度。
儿科渗透率与医疗机构利用率的反比关系支持了在未拨打毒理中心电话时过度利用医疗保健的先前观察结果。由于种族、语言和距离是利用毒理中心的障碍，并且随着渗透率下降，医疗利用率增加，因此低渗透率表明对毒理中心的认识不足，而不是中毒发生率低。
提高渗透率的策略应该基于对利用障碍的理解，包括语言、黑种人/非裔美国人种族、距离毒理中心的远近、贫困和较低的教育水平。
