Poison center consultation reduces hospital length of stay. Clin Toxicol (Phila) 2022 Jul;60(7):863-868
Date
03/10/2022Pubmed ID
35261300DOI
10.1080/15563650.2022.2039686Scopus ID
2-s2.0-85126341910 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
CONTEXT: Prior studies have observed shorter lengths of stay when practitioners consult a US poison control center (PCC) regarding hospitalized toxicology patients, but the most recent study used data from 2010. Since then, the implementation of the Affordable Care Act, a trend toward shorter hospitalizations and substantial adjustments in hospital charges have occurred.
METHODS: This is a retrospective study of administrative hospital data and poison center data obtained from the Wisconsin Hospital Association and Wisconsin Poison Center for patients treated from 2010 to 2017. Stratified analysis was used to investigate the potential effects of PCC consultation on hospitalization. Univariate and multivariable regression analysis was used to characterize which factors were associated with an increased rate of PCC consultation.
DISCUSSION: 127,224 hospitalized cases were found, of which 44,628 were entered into a stratified hospital charge and length of stay analysis. PCC consultation was associated with an 11.6 h (95% CI 10.4-13.0 h) shorter mean length of stay overall, with children aged 0-6 having a larger reduction of 1.18 days. While total charges were higher by $600 in PCC consultation cases in the overall analysis (95% CI $390-$777), mean charges in patients aged 0-6 were $6695 lower when the PCC was consulted. PCC consultation was more likely to occur in cases involving children and adolescents, intentional overdoses (versus accidental or unknown intent), and women.
CONCLUSIONS: Our findings suggest that PCC consultation should be encouraged to potentially shorten hospitalizations of poisoned patients, and for pediatric patients in particular. Intentionality and demographic factors affect the rate of PCC consultation for overdose, but the nature of these relationships is unclear.
Author List
Farkas A, Kostic M, Huang CC, Gummin DAuthors
Andrew N. Farkas MD Associate Professor in the Emergency Medicine department at Medical College of WisconsinMark Kostic MD Professor in the Emergency Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentChild
Drug Overdose
Female
Hospitals
Humans
Length of Stay
Patient Protection and Affordable Care Act
Poison Control Centers
Poisons
Referral and Consultation
Retrospective Studies
United States
