Comparison of Incidence of Hospital Utilization for Poisoning and Other Injury Types
Comparison of Incidence of Hospital Utilization for Poisoning and Other Injury Types
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DOI：
10.1177/003335491112600113
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发表时间：
2011-01-01
影响因子：
3.3
通讯作者：
Singleton, Michael D.
中科院分区：
文献类型：
--
作者：
Spiller, Henry A.;Singleton, Michael D.
目标.我们调查了医院利用伤害的发生率，并将中毒与其他形式的伤害进行了比较。以前的研究表明，中毒控制中心通过减少医院利用率来降低医疗费用。我们对2008年在肯塔基州急诊医院接受损伤治疗的患者进行了为期一年的回顾性研究。我们还比较了住院患者出院与急诊科（艾德）直接出院的情况，以确定住院率。主要数据来源为肯塔基州医院账单数据库和肯塔基州地区毒物控制中心（KRPCC）数据库。2008年，肯塔基州有377,642人因受伤住院。最常见的损伤机制是福尔斯跌倒、被/撞击、机动车交通事故和用力过度。三种伤害原因的住院率高于平均值一个标准差：中毒（41.3%），枪支（38.4%）和溺水（22.4%）。同年，KRPCC报告了46，258起中毒事件，其中76.5%的患者在医疗机构外接受治疗，11.4%的患者接受治疗并从艾德出院，7.1%的患者接受住院治疗，2.3%的患者接受精神病治疗，2.7%的患者失访。三个原因的伤害有最大的比例住院病人的医疗服务中毒，枪支，溺水，这表明在这些伤害的严重程度高，提出了ED。我们认为，可用性和使用的中毒控制中心减少了医院利用中毒主要是通过管理大量的低严重程度的病人在医院系统之外。
Objectives. We investigated the incidence of hospital utilization for injuries and compared poisoning with other forms of injury. Previous studies have suggested poison control centers reduce health-care costs by decreasing hospital utilization.Methods. We conducted a one-year retrospective study involving patients treated for injuries at acute-care hospitals in Kentucky in 2008. We also compared inpatient discharges with discharges directly from the emergency department (ED) to determine hospitalization rates. The primary data sources were the Kentucky Hospital Billing database and the Kentucky Regional Poison Control Center (KRPCC) database.Results. In 2008, there were 377,642 hospital encounters for injuries in Kentucky. The most common mechanisms of injury were falls, struck by/against, motor vehicle traffic crashes, and overexertion. Three causes of injury were greater than one standard deviation above the mean in percentage of inpatient admissions: poisoning (41.3%), firearms (38.4%), and drowning (22.4%). During this same year, KRPCC reported 46,258 poisonings, with 76.5% of patients managed outside of a health-care facility, 11.4% of patients treated and released from the ED, 7.1% of patients admitted to inpatient care, 2.3% of patients admitted to psychiatric care, and 2.7% lost to follow-up.Conclusions. Three causes of injury had the greatest percentage of patients admitted for inpatient medical care-poisoning, firearms, and drowning-suggesting a high level of severity in these injuries presenting to the ED. We believe availability and use of a poison control center reduced hospital utilization for poisoning primarily by managing a large number of low-severity patients outside of the hospital system.