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  • Hospital referrals of patients with acute poisoning by the Belgian Poison Centre: analysis of characteristics, associated factors, compliance and costs

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Original research
Hospital referrals of patients with acute poisoning by the Belgian Poison Centre: analysis of characteristics, associated factors, compliance and costs
  1. Anne-Marie Katrien Descamps1,2,
  2. Dominique Vandijck3,4,
  3. Walter Buylaert5,
  4. Martine Mostin6,
  5. Peter De Paepe5
  1. 1 Pharmacology, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
  2. 2 Biomedical Sciences, Hasselt University, Faculty of Medicine and Life Sciences, Hasselt, Belgium
  3. 3 Public Health and Health Economics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
  4. 4 Faculty of Business Economics, Hasselt University, Hasselt, Belgium
  5. 5 Emergency Medicine, Ghent University, Faculty of Medicine and Life Sciences, Ghent, Belgium
  6. 6 Belgian Poison Centre, Brussels, Belgium
  1. Correspondence to Dr Anne-Marie Katrien Descamps, Pharmacology, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium; annemarie_descamps{at}yahoo.com

Abstract

Objective Aims were (1) to assess the characteristics, associated factors and compliance of patients with acute poisoning advised by the Belgian Poison Centre (BPC) to go (conditionally) to the hospital, (2) to assess the compliance and potential health-economic impact.

Methods Three types of referrals to the hospital of patients who called the BPC between 1 January and 30 June 2018 were analysed: referrals in case of deterioration in the patient’s condition (Hosp-watchful-wait), referrals (Hosp-referral) or urgent referrals (Hosp-urgent-referral). Factors associated with type of recommendation were registered. A survey was conducted on a second dataset of patients who called the BPC between 1 March and 15 May 2019 and referred (conditionally) to the hospital.

Results 5476 referrals were included: 72.4% accidental poisoning, 25.3% intentional self-harm, 1.2% substance abuse and 1.1% unclear intentionality. There were 2368 (43.2%) Hosp-watchful-wait cases, 2677 (48.9%) Hosp-referrals and 431 (7.9%) Hosp-urgent-referrals. In Hosp-watchful-wait cases, soaps and detergents were represented most (20.5%). In Hosp-referrals and Hosp-urgent-referrals, benzodiazepines (12.7% and 15.1%, respectively) predominated. Factors associated with hospitalisation type were number of symptoms, intentionality, type of agent(s) involved and advising antidotes. The survey showed that 7.8% of Hosp-watchful-wait patients went to the hospital versus 57.3% of Hosp-referrals and 59.6% of Hosp-urgent-referrals. The mean cost for Hosp-watchful-wait patients, Hosp-referrals and Hosp-urgent-referrals was estimated at €127, €767 and €796, respectively.

Conclusion Only a small proportion of patients followed the advice of the BPC to go (conditionally) to the hospital. A systematic follow-up of cases is warranted to examine the appropriateness of referrals and the compliance of patients.

  • emergency department
  • prehospital care
  • cost efficiency
  • poisoning
  • hospitalisations

Data availability statement

Data are available upon reasonable request. Deidentified participant data are available via the Belgian Poison Centre upon reasonable request. Reuse is permitted after permission of the authors.

https://doi.org/10.1136/emermed-2019-209202

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    Data availability statement

    Data are available upon reasonable request. Deidentified participant data are available via the Belgian Poison Centre upon reasonable request. Reuse is permitted after permission of the authors.

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    Footnotes

    • Handling editor Gene Yong-Kwang Ong

    • Contributors A-MKD analysed and interpreted the data and was responsible for writing the manuscript. WB was a major contributor in writing and revising the manuscript. PDP and DV substantively revised the manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.