title: The costs and outcomes of restricting public access to poison control centers. Results from a natural experiment.
abstract: OBJECTIVE
  The authors examined the costs and outcomes resulting from a natural experiment during which direct public access to poison control centers was restricted and then restored.
  
  
  METHODS
  Both societal and health care purchaser perspectives were used. Probability data were obtained from a natural experiment during which public callers from a large county in California were electronically blocked from directly accessing the poison control center. Callers were referred to 911, which had direct access to the poison control center, if they thought they had a poisoning emergency. We conducted telephone interviews of: (a) persons who attempted to call the poison control center for a child's poisoning exposure but who did not have direct access (n = 270) and (b) persons who called the poison control center after direct access was restored (n = 279). Cost data were obtained from primary data collection and from other sources. The outcome measure was the appropriateness of the treatment location (at home or at a health care facility). Caller-reported outcomes were also examined.
  
  
  RESULTS
  The average additional cost per blocked call was $10.89 from a societal perspective, or $33.14 from a health care purchaser perspective. Fourteen percent of callers with restricted access were treated at an inappropriate location, compared with only 2% of callers with direct poison control center access. Also, 14% did not obtain any professional advice after they attempted to call the poison control center, although 66% of these cases involved potentially toxic substances. Results were robust across a range of sensitivity analyses.
  
  
  CONCLUSIONS
  Restricting direct public access to poison control centers created additional costs to society, the health care sector, and callers.
authors.affiliation: Institute for Health Policy Studies, University of California, San Francisco, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Phillips
authors.forename: R K
authors.initials: RK
authors.lastname: Homan
authors.forename: P H
authors.initials: PH
authors.lastname: Hiatt
authors.forename: H S
authors.initials: HS
authors.lastname: Luft
authors.forename: T E
authors.initials: TE
authors.lastname: Kearney
authors.forename: S E
authors.initials: SE
authors.lastname: Heard
authors.forename: K R
authors.initials: KR
authors.lastname: Olson
mesh_terms: D002140:California; D003661:Decision Support Techniques; D003663:Decision Trees; D017048:Health Care Costs; D019981:Health Care Sector; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data*; D011039:Poison Control Centers / Q000191:economics / Q000706:statistics & numerical data*; D011336:Probability; D012680:Sensitivity and Specificity; D014481:United States