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）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。这项研究是对国际移民组织报告的回应，它测试了一种确定幼儿中毒发生率的方法。本研究将检查联系中毒控制中心（PCC）寻求建议（随后遵循）的中毒暴露，与联系PCC寻求建议（未遵循）的中毒暴露，以及代替最初PCC联系的紧急（艾德）/紧急护理。将确定未能联系PCC的促成因素和成本。基于初步研究，电子记录的回顾性审查将链接来自三个来源的数据：PCC毒物暴露电话，医院行政急诊科/紧急护理/住院数据，以及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中西部城市地区6岁以下的儿童，这些儿童向区域认证PCC报告了中毒暴露和/或在当地儿童医院艾德/紧急护理中心接受了治疗。将排除中毒电话或昆虫叮咬或蜜蜂叮咬的艾德/紧急护理访视。将在4年期间（2001-2004年）审查大约22 725个PCC电话和600个艾德/紧急护理访问。使用概率记录链接软件，将对来自三个来源的数据进行标准化，然后通过现有标识符进行系统链接。每年将计算特定的中毒发生率，以及PCC依从性、不依从性和未能联系PCC的情况。将使用逻辑回归分析确定导致未能联系PCC的因素。中毒仍然是一个主要的公共卫生问题，在医疗保健资金和资源方面可能是昂贵的。中毒对幼儿、少数民族和低收入者的影响尤为严重。这项研究将制定一个更全面的年龄特定的中毒发生率，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措施在减少幼儿中毒和减少不适当的艾德使用中毒的影响。

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.