THE COSTS AND OUTCOMES OF RESTRICTING PUBLIC-ACCESS TO POISON CONTROLCENTERS - RESULTS FROM A NATURAL EXPERIMENT

OBJECTIVES. The authors examined the costs and outcomes resulting from a natural experiment during which direct public access to poison cont rol centers was restricted and then restored. METHODS. Both societal a nd 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, whi ch had direct access to the poison control center, if they thought the y 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 wa s restored (n = 279). Cost data were obtained from primary data collec tion and from other sources. The outcome measure was the appropriatene ss of the treatment location (at home or at a health care facility). C aller-reported outcomes were also examined. RESULTS. The average addit ional 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 locati on, compared with only 2% of callers with direct poison control center access. Also, 14% did not obtain any professional advice after they a ttempted to call the poison control center, although 66% of these case s involved potentially toxic substances. Results were robust across a range of sensitivity analyses.CONCLUSION. Restricting direct public ac cess to poison control centers created additional costs to society, th e health care sector, and callers.