Poison center consultation reduces hospital length of stay
Poison center consultation reduces hospital length of stay
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DOI：
10.1080/15563650.2022.2039686
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发表时间：
2022-03-08
影响因子：
3.3
通讯作者：
Gummin, David
中科院分区：
文献类型：
--
作者：
Farkas, Andrew;Kostic, Mark;Gummin, David
背景以前的研究已经观察到，当从业者向美国毒物控制中心（PCC）咨询住院毒理学患者时，住院时间较短，但最近的研究使用了2010年的数据。自那时以来，《平价医疗法》的实施，出现了缩短住院时间和大幅调整医院收费的趋势。方法这是一项回顾性研究，分析了从威斯康星州医院协会和威斯康星州中毒中心获得的2010年至2017年接受治疗的患者的管理医院数据和中毒中心数据。采用分层分析方法探讨PCC咨询对住院的潜在影响。单变量和多变量回归分析用于描述哪些因素与PCC咨询率增加相关。讨论发现127，224例住院病例，其中44，628例进入分层住院费用和住院时间分析。PCC咨询与总体平均住院时间缩短11.6小时（95%CI 10.4-13.0小时）相关，0-6岁儿童的住院时间缩短幅度更大，为1.18天。虽然在总体分析中，PCC咨询病例的总费用高出600美元（95% CI 390 - 777美元），但当咨询PCC时，0-6岁患者的平均费用低6695美元。PCC咨询更可能发生在涉及儿童和青少年、故意过量（与意外或未知意图相比）和女性的病例中。结论我们的研究结果表明，PCC咨询应鼓励潜在缩短中毒患者的住院时间，特别是对儿科患者。意向性和人口统计学因素会影响因用药过量而进行PCC咨询的比率，但这些关系的性质尚不清楚。
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.