Kearney T E, Olson K R, Bero L A, Heard S E, Blanc P D
San Francisco Injury Center, San Francisco General Hospital, CA 94110, USA.
West J Med. 1995 Jun;162(6):499-504.
Poison control centers in the United States are threatened with closure, and attempts at a cost-benefit analysis of these services have been indeterminate. The purpose of this study was to compare the operating costs of a regional poison control center resulting from public use of its telephone hotline services with those of hypothetical alternative sources of advice and care. We conducted a follow-up telephone survey among 589 public callers to the San Francisco Bay Area Regional Poison Control Center who had been managed at home without medical referral after an unintentional poisoning. All survey respondents were asked what alternative action they would have taken had the poison control center not been available to assist them by telephone consultation. We then surveyed emergency departments and physicians' offices cited as alternatives by the callers to determine their response and charges for evaluating a suspected poisoning case. A total of 464 (79%) of the callers surveyed would have sought assistance from their local emergency health care system had the poison control center not been available. We conservatively estimated that the total charges for such evaluations would be +71,900. Comparatively, the total actual operating cost of services provided by the poison control center for all 589 poisoning cases was +13,547. Most of the study subjects (429 [73%]) had private insurance coverage. Direct public access to these services probably reduces the use of emergency health care resources, thus lowering health care costs.
美国的毒物控制中心面临关闭的威胁，而对这些服务进行成本效益分析的尝试尚无定论。本研究的目的是比较一个区域毒物控制中心因其电话热线服务被公众使用而产生的运营成本，与假设的替代咨询和护理来源的成本。我们对旧金山湾区区域毒物控制中心的589名公众来电者进行了后续电话调查，这些来电者在意外中毒后在家中接受处理，未被转诊至医疗机构。所有接受调查的受访者都被问及，如果毒物控制中心无法通过电话咨询为他们提供帮助，他们会采取什么替代行动。然后，我们对来电者提到的作为替代方案的急诊科和医生办公室进行了调查，以确定他们对评估疑似中毒病例的反应和收费情况。在接受调查的来电者中，共有464人（79%）表示，如果毒物控制中心无法提供帮助，他们会向当地的紧急医疗保健系统寻求帮助。我们保守估计，此类评估的总费用将为71,900美元。相比之下，毒物控制中心为所有589例中毒病例提供服务的实际总运营成本为13,547美元。大多数研究对象（429人[73%]）拥有私人保险。公众直接使用这些服务可能会减少紧急医疗保健资源的使用，从而降低医疗保健成本。
