Poison control centers: can their value be measured?

Most regions of the United States are served by poison control centers that provide 24-hour toxicologic guidance resulting in the home management of most poison exposures. It has been suggested that without public access to a poison control hotline the majority of poison-exposed patients would seek medical care in emergency departments or other outpatient visits. This study compares the patterns of community response to poison exposure in Louisiana before and after the discontinuance of the state poison control service, and also compares these patterns to the situation in Alabama, which maintained poison center services throughout the study period. After discontinuance of the poison control service in Louisiana, poison exposure cases had up to four times the rate of "self-referral" to health care facilities and less than half the rate of home management when compared to Alabama cases. Before the closing of the Louisiana center, Alabama and Louisiana triage patterns for poison exposures were nearly identical. The maximum annual cost attributable to unnecessary outpatient service utilization in Louisiana was estimated to be $1.4 million, an amount more than three times the annual poison control center state appropriation.