Poisoning Incidence and ED Use/Misuse in Young Children

描述（由申请人提供）：2004年医学研究所（IOM）的报告“建立中毒预防和控制系统”呼吁对中毒进行流行病学研究。研究表明，一个数据来源不能充分反映中毒发生率。这项研究通过测试一种确定幼儿中毒发生率的方法来回应国际医学组织的报告。本研究将检查在接触中毒控制中心（PCC）寻求建议并随后得到遵循的情况下的中毒暴露情况，与那些接触中毒控制中心（PCC）寻求建议但未得到遵循的情况相比，与急诊(ED)/紧急护理代替最初联系PCC的情况相比。将确定未能与投诉协调委员会联系的影响因素和成本。在初步研究的基础上，这项电子记录的回顾性审查将链接三个来源的数据：PCC中毒呼叫、医院行政急诊科/紧急护理/住院患者数据和机构国家电子伤害监测系统（NEISS）数据。电子记录审查将仅限于来自中西部城市地区的6岁以下儿童，这些儿童向地区认证的PCC报告了中毒暴露和/或在当地儿童医院急诊科/紧急护理中心接受治疗。中毒电话或因昆虫叮咬或蜜蜂叮咬而就诊的急诊科/紧急护理将被排除在外。在4年期间（2001-2004年），将审查大约22,725次PCC电话和600次急诊科/紧急护理就诊。使用概率记录链接软件，来自三个来源的数据将被标准化，然后通过现有标识符系统地链接。将每年计算特定年龄的中毒发生率，以及PCC符合性、不符合性和未能与PCC联系。导致未能与PCC联系的因素将使用逻辑回归分析来确定。中毒仍然是一个重大的公共卫生问题，可能耗费医疗费用和资源。中毒对儿童、少数民族和低收入者的影响尤为严重。本研究将制定更全面的年龄特异性中毒发生率，确定非pcc依从率，并确定非pcc使用模式。本研究中测试的方法将用于后续研究，以监测中毒发生率的趋势，确定目标人群，并确定标准化教育干预在减少幼儿中毒和减少因中毒而不适当使用ED方面的影响。

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.