Poisoning Incidence and ED Use/Misuse in Young Children

点击翻译按钮获取中文摘要

DESCRIPTION (Provided by Applicant): The 2004 Institute of Medicine (IOM) report "Forging a Poison Prevention and Control System" calls for epidemiological research of poisonings. Studies have shown that one data source does not adequately capture poisoning incidence. This study responds to the IOM report by testing a methodology to determine the incidence of poisonings to young children. This study will examine poison exposures where the poison control center (PCC) was contacted for advice which was subsequently followed, versus those where the PCC was contacted for advice which was not followed, versus emergency (ED)/urgent care in lieu of initial PCC contact. Contributing factors and costs of failure to contact the PCC will be determined. Based on preliminary research, this retrospective review of electronic records will link data from three sources: PCC poison exposure calls, hospital administrative emergency department/urgent care/inpatient data, and institutional National Electronic Injury Surveillance System (NEISS) data. Electronic record reviews will be limited to children less than 6 years old from a Midwestern urban area with a poisoning exposure reported to the regional certified PCC and/or treated at the local children's hospital ED/urgent care centers. Poisoning calls or ED/urgent care visits for insect bites or bee stings will be excluded. Approximately 22,725 PCC calls and 600 ED/urgent care visits will be reviewed for a 4 year period (2001-2004). Using probabilistic record linkage software, data from the 3 sources will be standardized and then systematically linked via existing identifiers. Age-specific poisoning incidence rates will be calculated annually as will PCC compliance, noncompliance, and failure to contact the PCC. Factors contributing to failure to contact the PCC will be determined using logistic regression analysis. Poisoning remains a major public health problem that can be costly in healthcare dollars and resources. Poisonings disproportionately affect young children, minorities, and low-income. This study will develop a more comprehensive age-specific poisoning incidence rate, determine rates on non-PCC compliance, and identify patterns in non-PCC use. The methodology tested in this study will be used in subsequent research to monitor trends in poisoning incidence, identify targeted populations, and determine the impact of a standardized educational intervention in reducing poisonings to young children and in reducing inappropriate ED use for poisonings.