Relationship Between Health Insurance Type and Choice of Non-poison Center Alternative Care

Abstract:

Background:

In a preliminary study, we identified that visiting an emergency department (ED) and calling a physician were substitute options if the poison control center (PCC) were not available. The objective of this study was to review multiple years of data to determine what callers to PCCs would do in a poison-related emergency if a PCC was not available, and whether or not health insurance is a factor that influences that decision.

Methods:

This was a retrospective analysis of a PCCs customer satisfaction survey (CSS) responses between 2015 to 2018 to determine the relationship between 2 survey questions.: 1) “If the poison center was not available, what would you do first in solving poison-related emergencies?” and 2) “Does the person you called about have health insurance? If yes, which kind is it?” The alternative actions are: call 911, call/visit ED, call/visit urgent care, call/visit physician, search online, and other. The insurance types are separated into four categories: government (state/federal), commercial, self-pay, and other/unknown/refused. The data were cross-tabulated for analysis.

Results:

A total of 3852 surveys were completed between 2015 to 2018. The majority of responders had commercial insurance (2500; 64.9%), followed by government (959; 24.9%). The top three most common alternative actions were call/visit physician (1030; 26.74%) followed by call/visit ED (963; 25%) and call 911 (788; 20.26%). For callers with government insurance, the most common alternative action response was call/visit ED (307; 32.01%); the most common response for callers with commercial insurance was call/visit physician (752; 30.08%); for self-pay, the most common response was visit ED (57; 35.19%); and for other/unknown/refused callers, the most common response was visit ED (55; 23.81%).

Conclusion:

If the PCC is not available, most callers will seek care at a healthcare facility with the two most common actions call/visit ED and call/visit physician depending on the insurance type. 

Published in College of Pharmacy, Virtual Poster Session Spring 2020

Responses

  1. This is probably hard to answer, but do think the preferences would be different among the people who do not call a PCC in the first place? I know the survey was for people who did call a PCC, and it makes me wonder what the most popular options are for people who are unaware of the PCC.

    1. That’s a good question. I don’t know the answer for sure on that one and it may be a good project for the future. But if I had to take a guess, I would think that going to the ED would still be in the top because they may see it as a more serious problem since they are unaware of the PCC.

  2. It’s great seeing your poster after being in the same project group and watching the development over the past two years. I think you did a good job representing the information in your manuscript throughout your poster. It’s is interesting that the actions within insurance groups did not substantially differ. Additionally, I think it’s comforting to see that the percentage of patients that would search online is at least fairly low… Great job!

    1. Thanks for the comment Lydia! I saw your poster and it looks great!

  3. Nice poster Angela! And important findings to help the poison center.

  4. Angela, What great information, and so well presented. Having worked with Dr. Crouch to try to get funding for the PCC, I know these type of data are so critical to document the value of the PCC. It is great to know that your work will benefit the center going forward. Well done!

    1. One question. Do you have any data on what the cost/call would be for each of those alternatives?

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