Estimation of emergency care cost savings based on caller survey data from a three-state regional poison center

Previous studies have shown poison centers (PCs) reduce healthcare costs, often by preventing unnecessary emergency care visits. An updated cost-savings estimate has not been recently conducted.

This was a retrospective study analyzing caller survey data for a three-state American PC, gathered from 2021 to 2024. The PC's annual budget is $3.3 million (M). Eligible cases included public callers whose poisoning question was managed on-site and later completed a post-call telephone survey, including the question, "What would you have done if the poison center was not available to you?" Emergency care costs were estimated using three variables to reflect costs rather than charges. Ambulance transport costs and physician professional fee reimbursements for emergency department (ED) evaluation and management (E&M) codes were calculated from the U.S. Centers for Medicare and Medicaid Services published data. Facility fees from the associated E&M codes were calculated based on a general reimbursement rate of 33% of charges from our PC's affiliated safety-net hospital. E&M codes 99284 and 99285 (levels of service [LOS] 4 and 5, respectively) were used to calculate a cost-savings range.

Among 1670 respondents to the survey (overall completion rate, 24%), 1346 (81%) would have immediately sought care; n = 916 [55%] of which would immediately call a healthcare professional while n = 430 [26%] would call 911 or go to the ED. Extrapolating survey results to our entire caller population, the estimated annual cost-savings from avoided emergency care visits for each state were as follows: Minnesota, $29.4 to 48.0 M; North Dakota, $5.0 to 5.7 M; South Dakota, $5.1 M to 7.5 M, for a benefit-to-cost ratio of $12.07 to $18.55:1. When factoring in our annual budget, this results in an annual net savings of $36.5 to 58.0 M for our three-state region. Sensitivity analysis, assuming all ED visits reimbursed at LOS 4 and that ambulance transports occurred less frequently and were less costly per transport, still demonstrated robust cost-savings, with a benefit-to-cost ratio of $6.22-6.88:1.

Using standard reimbursement data, we demonstrated our poison center likely saves our three-state region more than six times its annual budget solely from preventing unnecessary emergency care visits.