Posters IV - The American Academy of Clinical Toxicology

available, management by a PC of human exposures occurring in their own residence, managed on site
(not HCF) avoided annual medical care costs of nearly $9 million; in the Medicaid subgroup, annual
medical care costs avoided were $4 million.
269
Health Policy and Poison Control Centers: Providing Analysis Utilizing a Logic Model
Teresa Dodd-Butera 1 , Molly Broderick 2
1 CSU San Bernardino, San Bernardino CA 2 California Poison Control System, San Diego CA USA
Background: Despite evidence that poison control centers (PCCs) provide cost-effective public health
measures and access, threats for decreased public funding necessitates improved evaluation methods. A
logic model provides an illustration of an underlying conceptual framework and the logical connection
within and between systems. Methods: A logic model was utilized to analyze the policy of decreasing
public spending for PCCs. An underlying assumption was that PCCs provide essential public health
services. Inputs included stakeholders and resources impacted by the policy to decrease public spending.
The logic model also considered negative outcomes for both outpatient and inpatient services which are
impacted if decreased funding levels lead to the elimination of access to PCC services. Results:
Immediate impact of decreased public spending would deny access to certain essential public health
services, particularly significant to vulnerable populations. Short and long-term outcomes would include
decreased utilization of appropriate resources; and increased costs and imposition on emergency services
and resources, respectively. In addition, there is a potential for increased morbidity and mortality due to an
absence of preventive services to the public and impediments to training of clinical toxicologists.
Conclusions: Logic models for analysis of public health policy for PCCs can be effective in establishing
causal models and connectedness of systems. In addition, it provides a conceptual and visual frame of
reference for professionals, politicians, and the public which increases transparency for fiscal decisions;
and eliminates the appearance of budget reduction in the case of decreased public spending for PCC
services, which would actually increase spending for other health services.
270
Follow-up calls: revision of the criteria and the procedure
Anne Letarte 1 , Veronique Gross 1 , Monique Dorval 1 , Rene Blais 1
1 Centre antipoison du Quebec (CAPQ), Quebec QC Canada
Background: At the CAPQ, the aim of the follow-up (FU) calls is to optimize the care of the intoxicated
patient by evaluating both the patient's response to the recommended treatment and the need for further
recommendations. The FU calls also serve to determine patient outcome in relation to the acute toxic
episode. With increasing workloads both at the CAPQ and in the critical care units, our specialists in
poison information (SPIs) were questioning the relevance of maintaining some FUs. The SPIs were also
asking for an update of the FU criteria. They wanted more objective criteria that would help them in
making clinical decisions as to whether or not to initiate or discontinue FU. As an organization, we aimed
to improve our patient outcome data. Method: The CAPQ created a workgroup that surveyed all of the
SPIs and the toxicologists for their specific suggestions to improve our FU criteria. The workgroup also
reviewed the American Association of Poison Control Centers' certification criteria concerning the
outcome data, and examined the FU procedures from four Canadian, two American and one European
poison control centres. Based on these data, the workgroup drafted a brand-new FU procedure which was
tested by the SPIs during the months of December 2010 and January 2011. Results: Following the test