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1.
Emerg Med J ; 38(7): 511-519, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32753396

RESUMO

OBJECTIVE: Aims were (1) to assess the characteristics, associated factors and compliance of patients with acute poisoning advised by the Belgian Poison Centre (BPC) to go (conditionally) to the hospital, (2) to assess the compliance and potential health-economic impact. METHODS: Three types of referrals to the hospital of patients who called the BPC between 1 January and 30 June 2018 were analysed: referrals in case of deterioration in the patient's condition (Hosp-watchful-wait), referrals (Hosp-referral) or urgent referrals (Hosp-urgent-referral). Factors associated with type of recommendation were registered. A survey was conducted on a second dataset of patients who called the BPC between 1 March and 15 May 2019 and referred (conditionally) to the hospital. RESULTS: 5476 referrals were included: 72.4% accidental poisoning, 25.3% intentional self-harm, 1.2% substance abuse and 1.1% unclear intentionality. There were 2368 (43.2%) Hosp-watchful-wait cases, 2677 (48.9%) Hosp-referrals and 431 (7.9%) Hosp-urgent-referrals. In Hosp-watchful-wait cases, soaps and detergents were represented most (20.5%). In Hosp-referrals and Hosp-urgent-referrals, benzodiazepines (12.7% and 15.1%, respectively) predominated. Factors associated with hospitalisation type were number of symptoms, intentionality, type of agent(s) involved and advising antidotes. The survey showed that 7.8% of Hosp-watchful-wait patients went to the hospital versus 57.3% of Hosp-referrals and 59.6% of Hosp-urgent-referrals. The mean cost for Hosp-watchful-wait patients, Hosp-referrals and Hosp-urgent-referrals was estimated at €127, €767 and €796, respectively. CONCLUSION: Only a small proportion of patients followed the advice of the BPC to go (conditionally) to the hospital. A systematic follow-up of cases is warranted to examine the appropriateness of referrals and the compliance of patients.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Intoxicação/classificação , Adolescente , Adulto , Idoso , Antídotos/economia , Antídotos/uso terapêutico , Bélgica/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Controle de Intoxicações/economia , Centros de Controle de Intoxicações/organização & administração , Centros de Controle de Intoxicações/estatística & dados numéricos , Intoxicação/economia , Intoxicação/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Encaminhamento e Consulta/tendências
2.
Pediatrics ; 145(2)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31988169

RESUMO

Chemical and biological events (including infectious disease outbreaks) may affect children disproportionately, and the threat of a chemical or biological attack remains in the United States and worldwide. Although federal programs and funding support a broad range of federal initiatives for public health preparedness and response, funding at the state and local levels has been flat or is decreasing, potentially leaving communities vulnerable. Consequently, pediatricians need to prepare and be ready to care for children in their communities before, during, and after a chemical or biological event, including during long-term recovery. Some medical countermeasures for particular chemical and biological agents have not been adequately studied or approved for children. The American Academy of Pediatrics provides resources and education on disaster preparedness and response, including information on the pediatrician's role in disasters, pediatric medical countermeasures, and mental health after an event as well as individual and family preparedness. This policy statement addresses the steps that clinicians and policy makers can take to protect children and mitigate the effects of a chemical or biological attack.


Assuntos
Bioterrorismo/psicologia , Terrorismo Químico/psicologia , Planejamento em Desastres , Pediatras , Papel do Médico , Bioterrorismo/classificação , Terrorismo Químico/classificação , Criança , Descontaminação/métodos , Atenção à Saúde/organização & administração , Órgãos Governamentais/organização & administração , Pessoal de Saúde , Humanos , Avaliação das Necessidades , Centros de Controle de Intoxicações/organização & administração , Estados Unidos
4.
Therapie ; 75(3): 239-251, 2020.
Artigo em Francês | MEDLINE | ID: mdl-31561915

RESUMO

Medication errors (ME) are frequently encountered and present at every step of the therapeutic process. This study's aims were to take stock of the ME reported to the region's pharmacovigilance (CRPV) and poison control centers (CAPTV) and to identify potential regional actions. A 2-months (January and February 2017) prospective gathering of the calls to the CAPTV regarding the ME and of the ME declarations to the region's CRPV (Clermont-Ferrand, Grenoble, Lyon, Saint-Etienne) has been carried out. The place of occurrence, the event's description and its consequences and data regarding the patient were collected. In addition to that, the regional drug observatory OMEDIT analysis has allowed to determine the ME's types (REMED characterization, never event?) and to look for the results of a potential thorough analysis. The study reported 580 calls for 590 ME and 583 patients. ME mostly affected the ambulatory/domicile sector (76%), the medico-social sector (14%) and the healthcare facilities sector (7%). It usually was about dose errors, medication errors and patient errors with a different profile in each sector. The majority of errors (85%) occurred at the administration step. Almost all the observed ME were confirmed errors having reached the patient (99.5%) but only a few had serious consequences. One out of 5 ME was eligible for a thorough analysis but even less were subjected to that kind of analysis. The main never event concerned the unidose in the ambulatory sector. The health products involved were mostly a single medication (75%) and then the patient's full treatment (12%). The CRPV/CAPTV/OMEDIT's skills are complementary for the gathering, the analysis and the management of the ME. Training campaigns and support are to be considered for the professionals and especially within the medico-social facilities.


Assuntos
Erros de Medicação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Criança , Pré-Escolar , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Doença Iatrogênica/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Farmacovigilância , Projetos Piloto , Centros de Controle de Intoxicações/organização & administração , Centros de Controle de Intoxicações/estatística & dados numéricos , Estudos Prospectivos , Gestão de Riscos , Adulto Jovem
5.
J Med Toxicol ; 15(1): 12-21, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30353414

RESUMO

INTRODUCTION: Morbidity and mortality from poison- and drug-related illness continue to rise in the USA. Medical toxicologists are specifically trained to diagnose and manage these patients. Inpatient medical toxicology services exist but their value-based economic benefits are not well established. METHODS: This was a retrospective study where length of stay (LOS) and payments received between a hospital with an inpatient medical toxicology service (TOX) and a similar hospital in close geographic proximity that does not have an inpatient toxicology service (NONTOX) were compared. Controlling for zip code, demographics and distance patients lived from each hospital, we used a fitted multivariate linear regression model to identify factors associated with changes in LOS and payment. RESULTS: Patients admitted to the TOX center had 0.87 days shorter LOS per encounter and the hospital received an average of $1800 more per patient encounter. CONCLUSION: In this study, the presence of an inpatient medical toxicology service was associated with decreased patient LOS and increased reimbursement for admitted patients. Differences may be attributable to improved direct patient care provided by medical toxicologists, but future prospective studies are needed.


Assuntos
Centros Médicos Acadêmicos/organização & administração , Serviços Médicos de Emergência/organização & administração , Hospitalização/economia , Tempo de Internação/economia , Centros de Controle de Intoxicações/organização & administração , Centros de Atenção Terciária/organização & administração , Atenção Terciária à Saúde/organização & administração , Estudos de Coortes , Custos e Análise de Custo , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Pacientes Internados/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pennsylvania , Estudos Prospectivos , Estudos Retrospectivos
6.
Br J Clin Pharmacol ; 85(1): 11-19, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30238503

RESUMO

AIMS: Presentations of intoxicated patients to hospital are frequent and increasing. We aimed to review the existing evidence that the presence of inpatient clinical toxicology services reduces use of resources without impacting on the care of these patients. METHODS: We conducted a literature search using the Cochrane Library, PubMed, and Embase for articles that measured length of stay (and other outcomes) for the target population, with toxicology services as an intervention. The articles were reviewed with respect to the ROBINS-I tool. RESULTS: Seven relevant articles were identified. Six of these studies demonstrated reduced hospital length of stay for intoxicated patients in hospitals with inpatient toxicology services. None of the articles demonstrated a detriment in morbidity or mortality. There were also improvements in other resource-related outcomes. CONCLUSIONS: The presence of inpatient toxicology services appears to improve resource utilization, in reduction of length of stay, as well as a number of other related outcomes. It does this without compromising on patient morbidity or mortality. Thus, it should be considered as a potential model of care for future toxicology services, especially with current trends of increasing demand for service efficiency.


Assuntos
Atenção à Saúde/organização & administração , Utilização de Equipamentos e Suprimentos/organização & administração , Centros de Controle de Intoxicações/organização & administração , Intoxicação/terapia , Utilização de Equipamentos e Suprimentos/estatística & dados numéricos , Mortalidade Hospitalar , Humanos , Tempo de Internação/estatística & dados numéricos , Centros de Controle de Intoxicações/estatística & dados numéricos , Intoxicação/mortalidade
7.
J Med Toxicol ; 13(1): 47-51, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27718162

RESUMO

BACKGROUND: The public commonly calls 911 for unintentional ingestions, rather than calling the local poison center. By utilizing a series of scripted questions, 911 dispatchers in Los Angeles determine if an ingestion meets "omega-1" classification. Under such circumstances, the regional poison center is contacted prior to dispatch of paramedics. If the poison center advises that the patient can remain at home, EMS is not dispatched and the patient is followed at home by the poison center. The primary objective is to determine the number of averted transports through involvement of a poison center. A secondary objective is to determine the potential costs and charges saved with the use of such a strategy. METHODS: A retrospective review of all overdose calls with an "omega-1" classification to a single EMS system between 1/2008-6/2012. Each call culminating in an EMS dispatch was subsequently reviewed by two additional reviewers. The cost savings was determined by utilizing data from the Medical Expenditure Panel Survey (MEPS) from 2000 to 2010. Monetary values were adjusted to 2012 dollars. RESULTS: Three hundred eighteen cases received "omega-1" dispatch classification. EMS was dispatched 19 times (5.98 %), and 11 patients (3.46 %) were ultimately transported. The most common reasons for transport were ambiguity over the ingested agent or amount, and caller insistence. Using these estimates, routine consultation of a regional poison center as part of EMS dispatch averted $486,595 in charges, and $183,279 in payments. CONCLUSIONS: Routine consultation of a poison center by emergency medical dispatchers can reduce unnecessary dispatches, ambulance transports, and ED visits with significant associated cost savings.


Assuntos
Overdose de Drogas/classificação , Serviços Médicos de Emergência/estatística & dados numéricos , Centros de Controle de Intoxicações/estatística & dados numéricos , Pessoal Técnico de Saúde , Redução de Custos , Overdose de Drogas/economia , Overdose de Drogas/terapia , Serviços Médicos de Emergência/economia , Serviços Médicos de Emergência/organização & administração , Humanos , Los Angeles , Centros de Controle de Intoxicações/economia , Centros de Controle de Intoxicações/organização & administração , Encaminhamento e Consulta , Estudos Retrospectivos
8.
Biosecur Bioterror ; 11(1): 75-80, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23458098

RESUMO

The impact of a severe influenza pandemic could be overwhelming to hospital emergency departments, clinics, and medical offices if large numbers of ill people were to simultaneously seek care. While current planning guidance to reduce surge on hospitals and other medical facilities during a pandemic largely focuses on improving the "supply" of medical care services, attention on reducing "demand" for such services is needed by better matching patient needs with alternative types and sites of care. Based on lessons learned during the 2009 H1N1 pandemic, the Centers for Disease Control and Prevention and its partners are currently exploring the acceptability and feasibility of using a coordinated network of nurse triage telephone lines during a pandemic to assess the health status of callers, help callers determine the most appropriate site for care (eg, hospital ED, outpatient center, home), disseminate information, provide clinical advice, and provide access to antiviral medications for ill people, if appropriate. As part of this effort, the integration and coordination of poison control centers, existing nurse advice lines, 2-1-1 information lines, and other hotlines are being investigated.


Assuntos
Acessibilidade aos Serviços de Saúde/organização & administração , Linhas Diretas/organização & administração , Influenza Humana/epidemiologia , Influenza Humana/terapia , Pandemias , Triagem/organização & administração , Centers for Disease Control and Prevention, U.S. , Humanos , Disseminação de Informação , Papel do Profissional de Enfermagem , Centros de Controle de Intoxicações/organização & administração , Parcerias Público-Privadas , Estados Unidos
9.
J Pharm Pract ; 26(3): 220-7, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22842499

RESUMO

The objective of this study was to evaluate pharmacist use of a Regional Poison Information Center (RPIC), identify potential barriers to utilization, and provide strategies to overcome these barriers. All calls placed to a RPIC by a pharmacist, physician, or nurse over a 5-year period were retrieved. These data were analyzed to assess the pharmacist utilization of the RPIC and the variation of call types. Additionally, a survey, designed to assess the past and future use of the RPIC by pharmacists, was distributed to pharmacists in the region. Of the 37,799 calls made to the RPIC, 26,367 (69.8%) were from nurses, 8096 (21.4%) were from physicians, and 3336 (8.8%) were from pharmacists. Among calls initiated by pharmacists, the majority involved medication identification (n = 2391, 71.7%). The survey had a 38.9% response rate (n = 715) and revealed a trend toward less RPIC utilization by pharmacists with more formal training but less practice experience. The utilization of the RPIC was lowest among pharmacists as compared to other health care professionals. This may be due to pharmacists' unfamiliarity with the poison center's scope of services and resources. Therefore, it is important that pharmacists are educated on the benefit of utilizing poison centers in clinical situations.


Assuntos
Assistência ao Paciente/métodos , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Centros de Controle de Intoxicações/estatística & dados numéricos , Pesquisas sobre Atenção à Saúde , Humanos , Enfermeiras e Enfermeiros/organização & administração , Enfermeiras e Enfermeiros/estatística & dados numéricos , Assistência Farmacêutica/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Médicos/organização & administração , Médicos/estatística & dados numéricos , Centros de Controle de Intoxicações/organização & administração , Estudos Retrospectivos
10.
Przegl Lek ; 69(8): 632-4, 2012.
Artigo em Polonês | MEDLINE | ID: mdl-23243951
11.
Toxicon ; 60(4): 700-5, 2012 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-22538194

RESUMO

Since 2008, a National Serum Depot is operational in the Netherlands, guaranteeing antivenom supply, 24 h per day, during medical emergencies. In this article the organisation structure, choice of antivenoms, problems encountered during the establishment, and the results from establishment in 2008 till December 2011 are discussed. The Serum Depot is organised by the National Institute for Public Health and the Environment in cooperation with the Dutch National Poisons Information Center. During establishing and maintaining of the Serum Depot several antivenom purchase difficulties were encountered. Some antivenom producers did not respond upon (initial) contact and some antivenoms were (temporarily) unavailable. Good contacts with professional herpetologists are necessary in order to keep the content of the depot up-to-date. At the same time, it is important to remain well informed concerning the safety and efficacy of the currently available antivenoms and development of new antivenoms. During the first four years of the National Serum Depot, the Dutch National Poisons Information Center was consulted on average 10 times a year about exotic venomous bites and stings in which antivenom treatment might play a role. Almost half of these consultations were related to bites by venomous exotic snakes, the other half to scorpion and fish stings. Antivenom was delivered in five cases, all after a bite by an exotic venomous snake, and actually administered twice because of the severity of local effects. To reduce costs and extend coverage of the Serum Depot of antivenoms for more unfamiliar snake species, international cooperation between the various owners of the antivenom Serum Depots in Europe is recommended.


Assuntos
Antídotos/provisão & distribuição , Antivenenos , Preparações Farmacêuticas/provisão & distribuição , Centros de Controle de Intoxicações/organização & administração , Antídotos/economia , Mordeduras e Picadas/tratamento farmacológico , Humanos , Países Baixos , Preparações Farmacêuticas/economia , Centros de Controle de Intoxicações/economia , Saúde Pública
12.
Am J Prev Med ; 38(6): 667-74, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20494245

RESUMO

In December 2002, the medical toxicology sub-board, which consists of representatives from emergency medicine, preventive medicine, and pediatrics, released revised core content for medical toxicology, aiming to better meet the academic challenges imposed by the continually expanding knowledge base of medical toxicology. These challenges included the addition of relatively new areas of interest in medical toxicology, including population health, while simultaneously ensuring that a structural framework existed to accommodate future areas of interest. There is no evidence readily available to assess how well the educational curricula of existing fellowship programs are meeting these needs. In an effort to address this, the authors describe a medical toxicology fellowship program that consists of a partnership among the Emory University School of Medicine, the Georgia Poison Control Center, and the CDC, as well as the results of a reorganization of its academic curriculum that occurred in 2006. To the best of the authors' knowledge, this is the first published report describing such a curriculum redesign. Suggestions and potential resources proposed as enhancements for the public health-associated education of medical toxicology fellows are discussed. The authors also seek to initiate a discussion among programs about how to optimally meet the new challenges developed by the medical toxicology sub-board.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Centros de Controle de Intoxicações/organização & administração , Toxicologia/educação , Centers for Disease Control and Prevention, U.S./organização & administração , Currículo , Bolsas de Estudo/organização & administração , Georgia , Humanos , Parcerias Público-Privadas/organização & administração , Faculdades de Medicina/organização & administração , Conselhos de Especialidade Profissional , Estados Unidos
13.
Clin Toxicol (Phila) ; 47(8): 790-1, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19778189

RESUMO

Federal funding of poison centers (PCs) in the United States was established in 2000 through the Poison Control Center Enhancement and Awareness Act. Unfortunately, the problems with financial stability of PCs that this legislation was intended to improve persist because of continued reliance on fragile local funding sources. In the past few months budget cuts have had an impact on PC activity and threaten the continued existence of a nationwide network of PCs in the United States. This commentary discusses the problems faced by PCs in this changing environment and illustrates the many competing tasks that the PC network performs for the U.S. population. PCs face continuing challenges in coming months and a unified approach at a national level may provide the best opportunity for a solution to this crisis.


Assuntos
Orçamentos , Financiamento Governamental , Política de Saúde/economia , Centros de Controle de Intoxicações/economia , Regionalização da Saúde/economia , Orçamentos/legislação & jurisprudência , Orçamentos/organização & administração , Redução de Custos , Financiamento Governamental/legislação & jurisprudência , Financiamento Governamental/organização & administração , Regulamentação Governamental , Política de Saúde/legislação & jurisprudência , Humanos , Objetivos Organizacionais , Centros de Controle de Intoxicações/legislação & jurisprudência , Centros de Controle de Intoxicações/organização & administração , Regionalização da Saúde/legislação & jurisprudência , Regionalização da Saúde/organização & administração , Governo Estadual , Estados Unidos
15.
Br J Clin Pharmacol ; 67(6): 687-90, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19594539

RESUMO

1. Detecting medication errors needs collaboration between various organizations, such as patient safety institutions, pharmacovigilance centres, and poison control centres. In order to evaluate the input of pharmacovigilance centres and poison control centres in detecting and evaluating medication errors a pilot project was initiated by the World Alliance for Patient Safety in collaboration with the Uppsala Monitoring Centre; the Moroccan pharmacovigilance centre acted as project coordinator. As part of this project, a questionnaire on detecting medication errors was circulated to pharmacovigilance centres and poison control centres around the world, in order to assess their ability to detect and analyse medication errors. 2. The results showed that through their databases pharmacovigilance centres can detect, identify, analyse, and classify medication errors and carry out root cause analysis, which is an important tool in preventing medication errors. 3. The duties of pharmacovigilance centres in preventing medication errors include informing health-care professionals about the importance of reporting such errors and creating a culture of patient safety. Pharmacovigilance centres aim to prevent medication errors in collaboration with poison control centres. Such collaboration allows improved detection and improved preventive strategies. In addition, collaboration with regulatory authorities is important in finalizing decisions. 4. Collaboration between pharmacovigilance centres and poison control centres should be strengthened and bridges need to be built linking pharmacovigilance centres, poison control centres, and organizations dedicated to patient safety, in order to avoid duplication of workload.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/organização & administração , Erros de Medicação/prevenção & controle , Centros de Controle de Intoxicações/organização & administração , Gestão de Riscos/organização & administração , Sistemas de Notificação de Reações Adversas a Medicamentos/normas , Humanos , Projetos Piloto , Centros de Controle de Intoxicações/normas
16.
Clin Toxicol (Phila) ; 47(5): 425-9, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19504736

RESUMO

INTRODUCTION: In 2007, medication identification requests (MIRs) accounted for 26.2% of all calls to U.S. poison centers. MIRs are documented with minimal information, but they still require an inordinate amount of work by specialists in poison information (SPI). An analysis was undertaken to identify options to reduce the impact of MIRs on both human and financial resources. METHODS: All MIRs (2003-2007) to a certified regional poison information center were analyzed to determine call patterns and staffing. The data were used to justify an efficient and cost-effective solution. RESULTS: MIRs represented 42.3% of the 2007 call volume. Optimal staffing would require hiring an additional four full-time equivalent SPI. An interactive voice response (IVR) system was developed to respond to the MIRs. DISCUSSION: The IVR was used to develop the Medication Identification System that allowed the diversion of up to 50% of the MIRs, enhancing surge capacity and allowing specialists to address the more emergent poison exposure calls. This technology is an entirely voice-activated response call management system that collects zip code, age, gender and drug data and stores all responses as .csv files for reporting purposes. The query bank includes the 200 most common MIRs, and the system features text-to-voice synthesis that allows easy modification of the drug identification menu. Callers always have the option of engaging a SPI at any time during the IVR call flow. CONCLUSIONS: The IVR is an efficient and effective alternative that creates better staff utilization.


Assuntos
Eficiência Organizacional , Centros de Controle de Intoxicações/organização & administração , Intoxicação/etiologia , Interface para o Reconhecimento da Fala , Automação , Análise Custo-Benefício , Humanos , Admissão e Escalonamento de Pessoal/organização & administração , Centros de Controle de Intoxicações/economia , Interface para o Reconhecimento da Fala/economia , Telefone , Fatores de Tempo , Recursos Humanos
18.
Clin Toxicol (Phila) ; 45(7): 787-90, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17952748

RESUMO

INTRODUCTION: The distinctive yellow Lance Armstrong 'Live Strong' silicon wristbands, which support cancer research, have reached iconic status and spawned substantial interest from other organizations seeking to capitalize on the same awareness opportunity. To promote the national toll-free Poison Help telephone number, a regional poison information center developed and introduced a Poison Help wristband. METHODS: The RPIC worked with a marketing firm to design the Poison Help wristband, conduct a feasibility analysis to determine the financial viability of the project and develop a plan to market and sell the wristbands. The wristbands were a unique color, contained the words Poison Help and the national toll-free telephone number. RESULTS: Approximately 50,000 wristbands were distributed in the first four months. CONCLUSIONS: By developing a practical application for a popular item, the RPIC increased poison center awareness and, as a secondary benefit, generated revenue to support other poison prevention education endeavors.


Assuntos
Publicidade/métodos , Acessibilidade aos Serviços de Saúde , Linhas Diretas/estatística & dados numéricos , Centros de Controle de Intoxicações/organização & administração , Intoxicação/prevenção & controle , Marketing Social , Humanos , Centros de Controle de Intoxicações/economia
20.
Clin Toxicol (Phila) ; 45(5): 440-50, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17503241

RESUMO

OBJECTIVES: To explore the effects of population, staffing, location, and funding on cost per human poison exposure call; and organizational characteristics differentiating higher- and lower-cost centers. METHODS: Data from 65 poison control centers (2001) were analyzed with linear multiple regression; qualitative data from 10 centers were compared. RESULTS: The most important predictor of expenses per call was 24-hour coverage by Specialists in Poison Information ($15.70 of $40.53/call). Other factors increasing total expenses included northeast location and more health educator FTEs. Qualitative information revealed that more complex organizational forms, including multiple reporting and accountability relationships, characterized higher-cost centers. Surprisingly, having a wider range of reported activities (less specialization) was more common among lower-cost centers. CONCLUSIONS: Wide variability in cost per call suggests that inefficiencies exist. While elimination of inefficient poison control centers could reduce costs, the loss of training and collaborative opportunities, and preparedness for public health emergencies and bio-terrorism events, might mitigate against such restructuring.


Assuntos
Centros de Controle de Intoxicações/economia , Custos e Análise de Custo , Linhas Diretas/economia , Humanos , Centros de Controle de Intoxicações/organização & administração , Estados Unidos
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