BC Injury Research and Prevention Unit (Rajabali, Turcotte, Zheng, Pike), BC Children's Hospital; Department of Emergency Medicine (Purssell), University of British Columbia; BC Drug and Poison Information Centre (Purssell, Buxton); School of Population and Public Health (Buxton), University of British Columbia; Department of Pediatrics (Pike), University of British Columbia, Vancouver, BC
BC Injury Research and Prevention Unit (Rajabali, Turcotte, Zheng, Pike), BC Children's Hospital; Department of Emergency Medicine (Purssell), University of British Columbia; BC Drug and Poison Information Centre (Purssell, Buxton); School of Population and Public Health (Buxton), University of British Columbia; Department of Pediatrics (Pike), University of British Columbia, Vancouver, BC.
CMAJ Open. 2023 Feb 14;11(1):E160-E168. doi: 10.9778/cmajo.20220089. Print 2023 Jan-Feb.
Poisoning, from substances such as illicit drugs, prescribed and over-the-counter medications, alcohol, pesticides, gases and household cleaners, is the leading cause of injury-related death and the second leading cause for injury-related hospital admission in British Columbia. We examined the health and economic costs of poisoning in BC for 2016, using a societal perspective, to support public health policies aimed at minimizing losses to society.
Costs by intent, sex and age group were calculated in Canadian dollars using a classification and costing framework based on existing provincial injury data combined with data from the published literature. Direct cost components included fatal poisonings, hospital admissions, emergency department visits, ambulance attendance without transfer to hospital and calls to the British Columbia Drug and Poison Information Centre (BC DPIC) not resulting in ambulance attendance, emergency care or transfer to hospital. Indirect costs, measured as loss of earnings and informal caregiving costs, were also calculated.
We estimate that poisonings in BC totalled $812.5 million in 2016 with $108.9 million in direct health care costs and $703.6 million in indirect costs. Unintentional poisoning injuries accounted for 84% of total costs, 46% of direct costs and 89% of indirect costs. Males accounted for higher proportions of direct costs for all patient dispositions except hospital admissions. Patients aged 25-64 years accounted for higher proportions of direct costs except for calls to BC DPIC, where proportions were highest for children younger than 15 years.
Hospital care expenditures represented the largest direct cost of poisoning, and lost productivity following death represented the largest indirect cost. Quantifying and understanding the financial burden of poisoning has implications not only for government and health care, but also for society, employers, patients and families.
中毒是不列颠哥伦比亚省（BC）导致与伤害相关的死亡的首要原因和导致与伤害相关的住院的第二大原因，中毒的原因包括非法药物、处方和非处方药物、酒精、农药、气体和家用清洁剂等物质。本研究从社会角度出发，检查了 2016 年 BC 中毒的健康和经济成本，旨在支持旨在使社会损失最小化的公共卫生政策。
采用基于现有省级伤害数据并结合文献数据的分类和成本框架，按意图、性别和年龄组计算加元成本。直接成本包括致命中毒、住院、急诊就诊、未转院的救护车出勤以及未导致救护车出勤、紧急护理或转院的不列颠哥伦比亚省药物和毒物信息中心（BC DPIC）来电。还计算了间接成本，即收入损失和非正规护理成本。
我们估计 2016 年 BC 的中毒总费用为 8.125 亿美元，其中直接医疗保健费用为 1.089 亿美元，间接费用为 7.036 亿美元。非故意中毒伤害占总费用的 84%，占直接费用的 46%，占间接费用的 89%。除住院外，所有患者处置的直接费用中，男性所占比例均高于女性；除 BC DPIC 来电外，所有患者处置的直接费用中，25-64 岁患者所占比例均高于其他年龄组，而 BC DPIC 来电中，15 岁以下儿童的比例最高。
医院护理支出是中毒的最大直接成本，死亡后的生产力损失是最大的间接成本。量化和了解中毒的经济负担不仅对政府和医疗保健具有重要意义，而且对社会、雇主、患者和家庭也具有重要意义。
