地区毒物控制中心的成本效益。

Cost-effectiveness of regional poison control centers.

作者信息

Harrison D L, Draugalis J R, Slack M K, Langley P C

机构信息

Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, USA.

出版信息

Arch Intern Med. 1996;156(22):2601-8.

PMID:8951304

Abstract

BACKGROUND

Poison exposures are a significant public health concern. Despite the impact that regional poison control centers have on reducing morbidity and mortality associated with poison exposures, they are facing a serious financial crisis today resulting in an increased emphasis on their economic justification.

METHODS

Using decision-analysis techniques, the cost-effectiveness of the treatment of poison exposures with the services of a regional poison control center compared with treatment without access to any poison control center was evaluated. The relative cost-effectiveness was modeled based on 2 outcomes (morbidity and mortality) for each of 4 typical poison exposures. Additionally, analyses were conducted to test the sensitivity of the cost-effectiveness ratios to outcome probability, average inpatient and emergency department costs, and proportion of poison exposures treated on site by the regional poison control center. A societal perspective was adopted.

RESULTS

The regional poison control center was substantially more cost-effective than the treatment of poison exposures without the services of a regional poison control center for both outcomes (morbidity and mortality) in each of the poison exposures considered. The results of the sensitivity analyses demonstrated that the outcomes of the decision analyses do not change regardless of the type of poison exposure, outcome considered, clinical outcome probabilities, average inpatient and emergency department costs, and proportion of poison-exposure cases treated on site by a regional poison control center.

CONCLUSIONS

The regional poison control center is consistently more cost-effective in the treatment of poison exposures with an average cost-effectiveness ratio (cost per successful outcome) approximately half of that achieved without the services of a regional poison control center. Finally, significant cost savings to society are realized for each additional successful outcome obtained with a regional poison control center.

摘要

背景

中毒暴露是一个重大的公共卫生问题。尽管地区中毒控制中心在降低与中毒暴露相关的发病率和死亡率方面具有重要作用，但它们如今正面临严重的财政危机，这导致人们更加重视其经济合理性。

方法

运用决策分析技术，评估了利用地区中毒控制中心的服务治疗中毒暴露与未使用任何中毒控制中心服务进行治疗相比的成本效益。基于4种典型中毒暴露中每种暴露的2种结果（发病率和死亡率）对相对成本效益进行建模。此外，还进行了分析，以测试成本效益比率对结果概率、平均住院和急诊科成本以及地区中毒控制中心现场治疗的中毒暴露比例的敏感性。采用社会视角。