Citation

Legg RG, Little M. Br. J. Clin. Pharmacol. 2019; 85(1): 11-19.

Affiliation

Consultant Toxicologist, NSW Poisons Information Centre, Australia.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/bcp.13768

PMID

30238503

Abstract

AIMS: Presentations of intoxicated patients to hospital are frequent and increasing. We aimed to review the existing evidence that the presence of inpatient clinical toxicology services reduces use of resources without impacting on the care of these patients.

METHODS: We conducted a literature search using the Cochrane Library, PubMed, and Embase for articles that measured length of stay (and other outcomes) for the target population, with toxicology services as an intervention. The articles were reviewed with respect to the ROBINS-I tool.

RESULTS: Seven relevant articles were identified. Six of these studies demonstrated reduced hospital length of stay for intoxicated patients in hospitals with inpatient toxicology services. None of the articles demonstrated a detriment in morbidity or mortality. There were improvements in other resource-related outcomes also.

CONCLUSIONS: The presence of inpatient toxicology services appears to improve resource utilisation, in reduction of length of stay, as well as a number of other related outcomes. It does this without compromising on patient morbidity or mortality. Thus, it should be considered as a potential model of care for future toxicology services, especially with current trends of increasing demand for service efficiency.

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Language: en

Keywords

Clinical toxicology; Health Economics; Health Policy; Overdose & Poisoning