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Journal of Medical Toxicology

, Volume 15, Issue 1, pp 12–21 | Cite as

The Effect of a Medical Toxicology Inpatient Service in an Academic Tertiary Care Referral Center

  • Andrew M. KingEmail author
  • Shooshan Danagoulian
  • Michael Lynch
  • Nathan Menke
  • Yijia Mu
  • Melissa Saul
  • Michael Abesamis
  • Anthony F. Pizon
Original Study

Abstract

Introduction

Morbidity and mortality from poison- and drug-related illness continue to rise in the USA. Medical toxicologists are specifically trained to diagnose and manage these patients. Inpatient medical toxicology services exist but their value-based economic benefits are not well established.

Methods

This was a retrospective study where length of stay (LOS) and payments received between a hospital with an inpatient medical toxicology service (TOX) and a similar hospital in close geographic proximity that does not have an inpatient toxicology service (NONTOX) were compared. Controlling for zip code, demographics and distance patients lived from each hospital, we used a fitted multivariate linear regression model to identify factors associated with changes in LOS and payment.

Results

Patients admitted to the TOX center had 0.87 days shorter LOS per encounter and the hospital received an average of $1800 more per patient encounter.

Conclusion

In this study, the presence of an inpatient medical toxicology service was associated with decreased patient LOS and increased reimbursement for admitted patients. Differences may be attributable to improved direct patient care provided by medical toxicologists, but future prospective studies are needed.

Keywords

Medical toxicology service Economics Quality of health care 

Notes

Sources of Funding

This study received the 2013 Medical Toxicology Foundation (MTF) Medical Toxicology Practice Award.

Compliance with Ethical Standards

Conflicts of Interest

None.

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Copyright information

© American College of Medical Toxicology 2018

Authors and Affiliations

  • Andrew M. King
    • 1
    Email author
  • Shooshan Danagoulian
    • 2
  • Michael Lynch
    • 3
    • 4
  • Nathan Menke
    • 5
  • Yijia Mu
    • 3
  • Melissa Saul
    • 3
  • Michael Abesamis
    • 3
  • Anthony F. Pizon
    • 3
    • 4
  1. 1.Wayne State University School of MedicineDetroitUSA
  2. 2.Department of EconomicsWayne State UniversityDetroitUSA
  3. 3.University of Pittsburgh School of MedicinePittsburghUSA
  4. 4.University of Pittsburgh Medical Center (UPMC)PittsburghUSA
  5. 5.Ohio Valley Medical CenterWheelingUSA

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