Staying at home: the potential cost savings related to triage advice provided by the New Zealand National Poisons Centre

Abstract

Introduction

Evidence from multiple countries suggests poisons centres create value in several ways including the provision of expert clinical advice, decreased hospital length of stay and triage of exposures enabling safe management without further medical utilisation. Data specific to the New Zealand context are lacking. Therefore, this study aimed to estimate one aspect of poison centre value, namely the potential savings to the health system related to triage advice provided by the New Zealand National Poisons Centre (NZNPC).

Methods

A prospective survey was conducted over a 2-week period where eligible NZNPC callers – who were advised their exposure did not require further medical assessment – were asked what alternative action they would have taken in the hypothetical absence of the NZNPC. The potential cost savings associated with the alternative actions respondents would have taken were calculated using publicly available information and extrapolated to the population level using annual NZNPC call numbers for 2019.

Results

Among 554 eligible callers, 399 were recruited to participate and 396 provided responses. The single most common alternative action was “search the Internet” (54/396, 14%). In-person medical assessment would have been sought by 25% (100/396), and 39% (154/396) would have called an alternative provider within the healthcare system. The estimated cost associated with alternative actions for the study period was NZ$25,637. When extrapolated to the 2019 year, the potential savings from avoided healthcare utilisation was NZ$1,061,551.

Conclusion

In 2019, in the absence of NZNPC triage advice, a conservatively estimated NZ$1,061,551 would have been spent on healthcare related to poisoning exposures that were appropriate for management without further medical utilisation. It is important to note that this estimate is only one aspect of the total value created by the NZNPC and is consistent with findings of value from other poisons centres internationally.

Keywords:

• Poison control centers
• cost savings
• triage
• health care costs
• poisoning

Acknowledgements

The authors would like to thank the staff of the New Zealand National Poisons Centre for assisting with the data collection for this study. Thanks also to Eeva-Katri Kumpula for providing helpful administrative data and thoughtful feedback on an early draft of this paper.

Disclosure statement

ACP is the director of the New Zealand National Poisons Centre. The other authors report no conflicts of interest.