Poison control centers and state-specific poisoning mortality rates.
OBJECTIVE
The purpose of this study was to compare poisoning mortality rates of states served by a poison control center certified by the American Association of Poison Control Centers (AAPCC) to those that are not served by a certified center because health policy has been based on certification status.


METHODS
Poisoning mortality rates from 1993 to 1997 were obtained from a public use database of death certificates and were stratified by state and circumstance. Each state was classified as being fully served, partially served, or not served by an AAPCC-certified center. States in one category of service for the entire 5 years were selected for analysis.


RESULTS
During this 5-year period, 39 states exhibited a consistent category of poison control center services. The mortality rates per 100,000 population during these 5 years were 5.93, 6.12, 6.01, 6.23, and 6.68 respectively (P <0.05) for all 39 states. The mean 5-year mortality rate for states with certified poison control center services (7.08 +/- 2.59; n = 17) was higher (P <0.05) than those with noncertified service (5.17 +/- 1.46; n = 15) but not significantly different from those with partial certified service (6.25 +/- 1.75; n = 7).


CONCLUSIONS
Increased poisoning mortality rates were associated with AAPCC certification status and year. Poisoning mortality rates may not be an appropriate outcome measure of the impact of poison control centers, AAPCC-certification notwithstanding, at this time. Basing poison control center-related policy on state-specific poisoning mortality rates can not be supported by these findings.
Chyka
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PA
Department of Pharmacy Practice and Pharmacoeconomics, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA. pchyka@utmem.edu
Somes
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GW
D002568:Certification; D006291:Health Policy; D006801:Humans; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000379:methods; D011039:Poison Control Centers / Q000592:standards* / Q000706:statistics & numerical data; D011041:Poisoning / Q000401:mortality*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology