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ECONOMIC EVALUATION OF POISON CENTERS: A SYSTEMATIC REVIEW

Published online by Cambridge University Press:  26 April 2012

Tais F. Galvao ,
Everton N. Silva ,
Marcus T. Silva ,
Alvin C. Bronstein  and
Mauricio G. Pereira
Tais F. Galvao
Affiliation:
University of Brasilia and Federal University of Amazonas email: taisgalvao@gmail.com
Everton N. Silva
Affiliation:
University of Brasilia
Marcus T. Silva
Affiliation:
University of Brasilia and Ministry of Health of Brazil
Alvin C. Bronstein
Affiliation:
Denver Health and Hospital Authority and University of Colorado Health Sciences Center
Mauricio G. Pereira
Affiliation:
University of Brasilia
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Abstract

Objectives: The aim of this study was to summarize and assess economic evaluations of poison centers (PCs) from the perspectives of society, the payer, and the healthcare system.

Methods: A systematic review was performed to identify complete economic evaluations regardless of the language or publication status. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool.

Results: In total, 422 non-duplicated studies were retrieved, but only nine met the eligibility criteria. Five of the eligible studies were published in the 1990s, and four were published in the 2000s. Six studies met at least seven of ten quality criteria. In all studies, the presence of PCs was compared with a scenario of their absence. Eight studies used cost–benefit analyses and one used a cost-effectiveness approach. The cost–benefit ratios ranged from 0.76 to 7.67, which indicates that each United States dollar (USD) spent on poison centers can save almost 8 USD on medical spending. A cost-effectiveness analysis showed that each successful outcome achieved by a PC avoids a minimum of 12,000 USD to 56,000 USD in other healthcare spending.

Conclusions: The data in our review show that PCs are economically viable. PCs improve the efficiency of healthcare expenditure and contribute to the sustainability of the healthcare system. An investment in PCs is a rational public health policy approach that contrasts the current trend of reducing spending on PCs.

Keywords

Poison control centersSystematic reviewEconomic evaluationCost–benefit analysisCost-effectiveness analysis
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 28 , Issue 2 , April 2012 , pp. 86 - 92
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

1.Anell, A, Persson, M. [Toxicologic information center's hotline–well-received and cost-effective for the society]. Lakartidningen. 2001;98:2926–2930.Google ScholarPubMed
2.Bindl, L, Ruchardt, J, Pfeiffer, A, Kowalewski, S, Lentze, MJ. Effect of a German poison control center on health care cost reductions in harmless exposure cases. Vet Hum Toxicol. 1997;39:48–50.Google Scholar
3.Blizzard, JC, Michels, JE, Richardson, WH, et al. Cost–benefit analysis of a regional poison center. Clin Toxicol (Phila). 2008;46:450–456.CrossRefGoogle ScholarPubMed
4.Bond, GR, Krenzelok, EP, Normann, SA, et al. Acetaminophen ingestion in childhood - cost and relative risk of alternative referral strategies. J Toxicol Clin Toxicol. 1994;32:513–525.CrossRefGoogle ScholarPubMed
5.Bottei, E, Kalin, L. State-based poison control center cost-effectiveness study. Clin Toxicol (Phila). 2004;42:816.Google Scholar
6.Briggs, AH. Handling uncertainty in cost-effectiveness models. Pharmacoeconomics. 2000;17:479–500.CrossRefGoogle ScholarPubMed
7.Bronstein, AC, Spyker, DA, Cantilena, LR Jr, et al. 2010 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 28th Annual Report. Clin Toxicol (Phila). 2011;49:910–941.CrossRefGoogle Scholar
8.CRD. Systematic reviews: CRD's guidance for undertaking reviews in health care. York, UK: University of York; 2009. http://www.york.ac.uk/inst/crd/SysRev/!SSL!/WebHelp/SysRev3.htm (accessed June 10, 2011).Google Scholar
9.Drummond, M, Sculpher, M, Torrance, G, O'Brien, B, Stoddart, G. Methods for the economic evaluation of health care programmes. 3rd ed.New York: Oxford University Press; 2005.CrossRefGoogle Scholar
10.Geller, RJ, Looser, RW. Cost saving from poison center use by medical consumers. Vet Hum Toxicol. 1985;27:521–521.Google ScholarPubMed
11.Giffin, S, Heard, SE. Budget cuts and U.S. Poison Centers - regional challenges create a nationwide problem. Clin Toxicol (Phila). 2009;47:790–791.CrossRefGoogle ScholarPubMed
12.Gold, MR, Siegel, JE, Russel, LB, Weinstein, MC. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.CrossRefGoogle ScholarPubMed
13.Harrison, DL, Draugalis, JR, Slack, MK, Langley, PC. Cost-effectiveness of regional poison control centers. Arch Intern Med. 1996;156:2601–2608.CrossRefGoogle ScholarPubMed
14.Higgins, JPT, Green, S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 ed: The Cochrane Collaboration; 2011. www.cochrane-handbook.org (accessed April 14, 2011).Google Scholar
15.Hilton, J, Wahl, M. Poison centers and medical cost avoidance: Revisiting the concept $7 saved for every $1 spent. Clini Toxicol (Phila). 2008;46:1.Google Scholar
16.IOM. Forging a poison prevention and control system. Washington, DC: The National Academies Press; 2004.Google Scholar
17.ISPOR. Pharmacoeconomic guidelines around the world. Lawrenceville, GA: International Society for Pharmacoeconomics and Outcomes Research; 2011. http://www.ispor.org/PEguidelines/index.asp (accessed June 10, 2011).Google Scholar
18.Kearney, TE, Olson, KR, Bero, LA, Heard, SE, Blanc, PD. Health-care cost effects of public use of a regional poison control center. West J Med. 1995;162:499–504.Google ScholarPubMed
19.Kolbelt, G.Health economics: An introduction to economic evaluation. 2nd ed.London: Office for Health Economics; 2002.Google Scholar
20.Litovitz, T, Benson, BE, Youniss, J, Metz, E. Determinants of U.S. poison center utilization. Clin Toxicol (Phila). 2010;48:449–457.CrossRefGoogle ScholarPubMed
21.LoVecchio, F, Curry, S, Waszolek, K, et al. Poison control centers decrease emergency healthcare utilization costs. J Med Toxicol. 2008;4:221–224.CrossRefGoogle ScholarPubMed
22.Meltzer MI. Introduction to health economics for physicians. Lancet. 2001;358:993–998.CrossRefGoogle Scholar
23.Miller, TR, Lestina, DC. Costs of poisoning in the united states and savings from poison control centers: A benefit-cost analysis. Ann Emerg Med. 1997;29:239–245.CrossRefGoogle ScholarPubMed
24.Phillips, KA, Homan, RK, Hiatt, PH, et al. The costs and outcomes of restricting public access to poison control centers - Results from a natural experiment. Med Care. 1998;36:271–280.CrossRefGoogle ScholarPubMed
25.Phillips, KA, Homan, RK, Luft, HS, et al. Willingness to pay for poison control centers. J Health Econ. 1997;16:343–357.CrossRefGoogle ScholarPubMed
26.Ponampalam, R. Cost benefits of the Drug and Poison Information Centre in preventing unnecessary hospitalisation: The Singapore experience. Hong Kong J Emerg Med. 2010;17:45–53.CrossRefGoogle Scholar
27.Rascati, K.Essentials of pharmacoeconomics. Philadelphia: Lippincott Williams & Wilkins; 2009.Google Scholar
28.Song, F, Parekh, S, Hooper, L, et al. Dissemination and publication of research findings: An updated review of related biases. Health Technol Assess. 2010;14:iii, ix-xi, 1-193.CrossRefGoogle ScholarPubMed
29.Sutter, ME, Bronstein, AC, Heard, SE, et al. The role of clinical toxicologists and poison control centers in public health. Am J Prev Med. 2010;38:658–662.CrossRefGoogle ScholarPubMed
30.Thompson, CA. Poison control centers suffer state budget cuts. Am J Health Syst Pharm. 2009;66:1682, 1684, 1687.CrossRefGoogle ScholarPubMed
31.Toverud, EL, Pike, E, Walloe, L. The National Poison Center in Norway: User satisfaction and a health economic evaluation. Eur J Clin Pharmacol. 2009;65:935–940.CrossRefGoogle Scholar
32.West, J, Taylor, L, Smith, N, Yu, JS. Cost savings through community access to the NSW Poisons Information Centre. Aust Health Rev. 1987;10:238–47.Google Scholar
33.WHO. Choosing interventions that are cost effective (WHO-CHOICE). Cost-effectiveness thresholds. Geneva: World Health Organization; 2005. http://www.who.int/choice/costs/CER_thresholds/en/index.html (accessed June 10, 2011).Google Scholar
34.WHO. World health statistics 2010. Geneva: World Health Organization; 2010. http://www.who.int/whosis/whostat/2010/en/index.html (accessed June 10, 2011).Google Scholar
35.Woolf, AD, Karnes, DK, Kirrane, BM. Preserving the United States's poison control system. Clin Toxicol (Phila). 2011;49:284–286.CrossRefGoogle ScholarPubMed
36.World Bank. Country and lending groups. http://data.worldbank.org/about/country-classifications/country-and-lending-groups (accessed September 09, 2011).Google Scholar
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