Accidental pediatric ingestion, hospital charges and failure to utilize a poison control center.
OBJECTIVE
Telephone contact with a poison control center may determine that accidental poison ingestion may not pose a risk of developing adverse clinical effect. Over 50% of reported human poisonings occur in children less than 6 years old. Yet most of these accidental childhood ingestions do not produce clinical toxicity. Such nontoxic ingestions can be managed by telephone rather than treated in a health care facility. This study evaluated the clinical effects produced, and the cost of emergency department care, versus obtaining telephone advice from a poison control center, following accidental poison ingestion in children age 6 and under.


METHODS
1 year review of all cases of accidental ingestion in children 6 years and under evaluated in a pediatric emergency department. Utilizing the hospital's poison control center criteria, cases were grouped as nontoxic (no risk of adverse effect) or toxic (significant risk for adverse effect). Groups were compared for demographics, clinical effect, dispositions, charges.


RESULTS
467 cases were seen; 141 met nontoxic criteria. Toxicity was not related to race or gender. Children age 2 and less accounted for the majority of cases (p = .003) [table: see text] Estimated poison control center costs are less than $25 per telephone call.


CONCLUSIONS
Significant charges are billed to health care payers when an emergency department is utilized as the primary means of evaluating children with nontoxic ingestions. Utilization of a poison control center as the initial means of intervention following an accidental pediatric ingestion results in significant savings in health care expenditures.
Stremski
E S
ES
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000191:economics; D011039:Poison Control Centers / Q000191:economics; D011041:Poisoning / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D011042:Poisons; D013689:Telephone; D014922:Wisconsin
D011042:Poisons