The association between U.S. Poison Center assistance and length of stay and hospital charges

Abstract Context. Poison centers (PCs) play an important role in poison prevention and treatment. Studies show that PCs reduce system-wide cost by reducing the number of unnecessary visits to emergency departments and by providing improved patient management. However, there remains a debate regardin...

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Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2014-03, Vol.52 (3), p.198-206
Main Authors: Friedman, L. S., Krajewski, A., Vannoy, E., Allegretti, A., Wahl, M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Child
Child, Preschool
Cost Savings
Female
Hospital Charges
Humans
Infant
Infant, Newborn
Length of Stay
Male
Middle Aged
Poison control center
Poison Control Centers
Poisoning
Poisoning - economics
Retrospective Studies
United States
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cited_by cdi_FETCH-LOGICAL-c418t-97f4742b8cc9ea608f234821cb259f19128da8200ba976451092b20c30f22bb23
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container_end_page 206
container_issue 3
container_start_page 198
container_title Clinical toxicology (Philadelphia, Pa.)
container_volume 52
creator Friedman, L. S.
Krajewski, A.
Vannoy, E.
Allegretti, A.
Wahl, M.
description Abstract Context. Poison centers (PCs) play an important role in poison prevention and treatment. Studies show that PCs reduce system-wide cost by reducing the number of unnecessary visits to emergency departments and by providing improved patient management. However, there remains a debate regarding the impact of PCs on patient outcomes at the hospital level. Objective. To evaluate the impact of PC involvement on length of hospitalization and total hospital charges. Materials and methods. We conducted a retrospective analysis of inpatient cases treated in Illinois hospitals in 2010. We linked the Illinois Poison Center database with an Illinois hospital billing dataset and controlled for important patient-level and facility-level covariates. Results. In the multivariable model, length of hospitalization among PC-assisted patients was 0.58 days shorter than that of patients without PC assistance (p < 0.001). Hospital charges for PC-assisted patients in the lower quintiles were significantly higher than patients without PC assistance (+$953; p < 0.001), but were substantially lower in the most costly quintile of patients (−$4852; p < 0.001). Balancing the higher charges for treating patients with PC assistance in the lower quintiles with the savings in the highest quintile, among inpatients there is a potential cumulative decrease of $2,078 in hospital charges per 10 patients. Discussion. Among the inpatient cases, PC assistance was associated with lower total charges only among the most expensive to treat. However, this outlier group is very important when discussing medical costs. It has been repeatedly shown that the majority of treatment costs are attributable to a small fraction of patients as seen in this study.
doi_str_mv 10.3109/15563650.2014.892125
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S. ; Krajewski, A. ; Vannoy, E. ; Allegretti, A. ; Wahl, M.</creator><creatorcontrib>Friedman, L. S. ; Krajewski, A. ; Vannoy, E. ; Allegretti, A. ; Wahl, M.</creatorcontrib><description>Abstract Context. Poison centers (PCs) play an important role in poison prevention and treatment. Studies show that PCs reduce system-wide cost by reducing the number of unnecessary visits to emergency departments and by providing improved patient management. However, there remains a debate regarding the impact of PCs on patient outcomes at the hospital level. Objective. To evaluate the impact of PC involvement on length of hospitalization and total hospital charges. Materials and methods. We conducted a retrospective analysis of inpatient cases treated in Illinois hospitals in 2010. We linked the Illinois Poison Center database with an Illinois hospital billing dataset and controlled for important patient-level and facility-level covariates. Results. In the multivariable model, length of hospitalization among PC-assisted patients was 0.58 days shorter than that of patients without PC assistance (p &lt; 0.001). Hospital charges for PC-assisted patients in the lower quintiles were significantly higher than patients without PC assistance (+$953; p &lt; 0.001), but were substantially lower in the most costly quintile of patients (−$4852; p &lt; 0.001). Balancing the higher charges for treating patients with PC assistance in the lower quintiles with the savings in the highest quintile, among inpatients there is a potential cumulative decrease of $2,078 in hospital charges per 10 patients. Discussion. Among the inpatient cases, PC assistance was associated with lower total charges only among the most expensive to treat. However, this outlier group is very important when discussing medical costs. It has been repeatedly shown that the majority of treatment costs are attributable to a small fraction of patients as seen in this study.</description><identifier>ISSN: 1556-3650</identifier><identifier>EISSN: 1556-9519</identifier><identifier>DOI: 10.3109/15563650.2014.892125</identifier><identifier>PMID: 24580060</identifier><language>eng</language><publisher>England: Informa Healthcare</publisher><subject>Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cost Savings ; Female ; Hospital Charges ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Male ; Middle Aged ; Poison control center ; Poison Control Centers ; Poisoning ; Poisoning - economics ; Retrospective Studies ; United States</subject><ispartof>Clinical toxicology (Philadelphia, Pa.), 2014-03, Vol.52 (3), p.198-206</ispartof><rights>2014 Informa Healthcare USA, Inc. 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-97f4742b8cc9ea608f234821cb259f19128da8200ba976451092b20c30f22bb23</citedby><cites>FETCH-LOGICAL-c418t-97f4742b8cc9ea608f234821cb259f19128da8200ba976451092b20c30f22bb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24580060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Friedman, L. S.</creatorcontrib><creatorcontrib>Krajewski, A.</creatorcontrib><creatorcontrib>Vannoy, E.</creatorcontrib><creatorcontrib>Allegretti, A.</creatorcontrib><creatorcontrib>Wahl, M.</creatorcontrib><title>The association between U.S. Poison Center assistance and length of stay and hospital charges</title><title>Clinical toxicology (Philadelphia, Pa.)</title><addtitle>Clin Toxicol (Phila)</addtitle><description>Abstract Context. Poison centers (PCs) play an important role in poison prevention and treatment. Studies show that PCs reduce system-wide cost by reducing the number of unnecessary visits to emergency departments and by providing improved patient management. However, there remains a debate regarding the impact of PCs on patient outcomes at the hospital level. Objective. To evaluate the impact of PC involvement on length of hospitalization and total hospital charges. Materials and methods. We conducted a retrospective analysis of inpatient cases treated in Illinois hospitals in 2010. We linked the Illinois Poison Center database with an Illinois hospital billing dataset and controlled for important patient-level and facility-level covariates. Results. In the multivariable model, length of hospitalization among PC-assisted patients was 0.58 days shorter than that of patients without PC assistance (p &lt; 0.001). Hospital charges for PC-assisted patients in the lower quintiles were significantly higher than patients without PC assistance (+$953; p &lt; 0.001), but were substantially lower in the most costly quintile of patients (−$4852; p &lt; 0.001). Balancing the higher charges for treating patients with PC assistance in the lower quintiles with the savings in the highest quintile, among inpatients there is a potential cumulative decrease of $2,078 in hospital charges per 10 patients. Discussion. Among the inpatient cases, PC assistance was associated with lower total charges only among the most expensive to treat. However, this outlier group is very important when discussing medical costs. 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S.</creatorcontrib><creatorcontrib>Krajewski, A.</creatorcontrib><creatorcontrib>Vannoy, E.</creatorcontrib><creatorcontrib>Allegretti, A.</creatorcontrib><creatorcontrib>Wahl, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical toxicology (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Friedman, L. S.</au><au>Krajewski, A.</au><au>Vannoy, E.</au><au>Allegretti, A.</au><au>Wahl, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between U.S. Poison Center assistance and length of stay and hospital charges</atitle><jtitle>Clinical toxicology (Philadelphia, Pa.)</jtitle><addtitle>Clin Toxicol (Phila)</addtitle><date>2014-03</date><risdate>2014</risdate><volume>52</volume><issue>3</issue><spage>198</spage><epage>206</epage><pages>198-206</pages><issn>1556-3650</issn><eissn>1556-9519</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Abstract Context. Poison centers (PCs) play an important role in poison prevention and treatment. Studies show that PCs reduce system-wide cost by reducing the number of unnecessary visits to emergency departments and by providing improved patient management. However, there remains a debate regarding the impact of PCs on patient outcomes at the hospital level. Objective. To evaluate the impact of PC involvement on length of hospitalization and total hospital charges. Materials and methods. We conducted a retrospective analysis of inpatient cases treated in Illinois hospitals in 2010. We linked the Illinois Poison Center database with an Illinois hospital billing dataset and controlled for important patient-level and facility-level covariates. Results. In the multivariable model, length of hospitalization among PC-assisted patients was 0.58 days shorter than that of patients without PC assistance (p &lt; 0.001). Hospital charges for PC-assisted patients in the lower quintiles were significantly higher than patients without PC assistance (+$953; p &lt; 0.001), but were substantially lower in the most costly quintile of patients (−$4852; p &lt; 0.001). 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source Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list)
subjects Adolescent
Adult
Aged
Child
Child, Preschool
Cost Savings
Female
Hospital Charges
Humans
Infant
Infant, Newborn
Length of Stay
Male
Middle Aged
Poison control center
Poison Control Centers
Poisoning
Poisoning - economics
Retrospective Studies
United States
title The association between U.S. Poison Center assistance and length of stay and hospital charges
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