Inpatient toxicology services improve resource utilization for intoxicated patients: a systematic review

Br J Clin Pharmacol. 2019 Jan;85(1):11-19. doi: 10.1111/bcp.13768. Epub 2018 Oct 28.

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 also improvements in other resource-related outcomes.

Conclusions: The presence of inpatient toxicology services appears to improve resource utilization, 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.

Keywords: clinical toxicology; health economics; health policy; overdose; poisoning.

Publication types

  • Systematic Review

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Equipment and Supplies Utilization / organization & administration*
  • Equipment and Supplies Utilization / statistics & numerical data
  • Hospital Mortality
  • Humans
  • Length of Stay / statistics & numerical data
  • Poison Control Centers / organization & administration*
  • Poison Control Centers / statistics & numerical data
  • Poisoning / mortality
  • Poisoning / therapy*