Thal Franziska, Reinhold Thomas
Kaufmännische Centrumsleitung CC05, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstraße 57, 10117, Berlin, Germany.
Arch Public Health. 2022 Nov 30;80(1):243. doi: 10.1186/s13690-022-00994-0.
Since establishing the first poison control centers (PCCs), there is a still ongoing debate regarding their relevance and financing. The present study aims to analyze whether a regional PCC can reduce the economic burden associated with utilization of health care structures due to low-risk poison exposures on the German health care system.
A decision-tree based cost-benefit analysis comparing a situation utilizing PCC consultation versus a hypothetical situation without PCC consultation for low-risk poison exposures from the German health care system's perspective was conducted. The model inputs were obtained by a representative telephone survey of lay callers supplemented by empirical PCC and literature data. A probabilistic and deterministic sensitivity analysis with varying input variables was performed to prove the robustness of the findings.
In the underlying telephone survey, data of 378 lay callers could be considered and included in the decision tree model. As a result, the mean costs for handling one low-risk poison exposure case were €41.99 utilizing PCC consultation compared to €145.92 without PCC consultation, indicating a cost-benefit ratio of 3.48 for the existence of the PCC. The sensitivity analysis proved that the outcome of the decision analysis does not change significantly with varying inputs.
The existence of PCCs relieve the burden on other health care providers and reduce health care costs to a relevant extent. Therefore, PCCs should be considered as an important supporting structure of the German health care system.
自首个中毒控制中心(PCC)设立以来,关于其相关性和资金问题的争论仍在持续。本研究旨在分析地区性PCC能否减轻德国医疗系统因低风险中毒暴露而使用医疗保健机构所带来的经济负担。
从德国医疗系统的角度出发,进行了一项基于决策树的成本效益分析,比较了利用PCC咨询的情况与假设无PCC咨询的低风险中毒暴露情况。模型输入数据通过对非专业来电者的代表性电话调查获得,并辅以PCC的实证数据和文献资料。通过改变输入变量进行概率性和确定性敏感性分析,以证明研究结果的稳健性。
在基础电话调查中,378名非专业来电者的数据可被纳入决策树模型。结果显示,利用PCC咨询处理一例低风险中毒暴露病例的平均成本为41.99欧元,而无PCC咨询时为145.92欧元,这表明PCC的存在成本效益比为3.48。敏感性分析证明,决策分析结果不会因输入变量的变化而显著改变。
PCC的存在减轻了其他医疗服务提供者的负担,并在相当程度上降低了医疗成本。因此,PCC应被视为德国医疗系统的重要支持结构。