van Herwerden Michael C, van Steenkiste Job, El Moussaoui Rachida, den Hollander Jan G, Helfrich Gea, J A M Verberk Iris
Maasstad Ziekenhuis, afd. Interne Geneeskunde,Rotterdam.
Contact: Michael C. van Herwerden (
Ned Tijdschr Geneeskd. 2021 Mar 11;165:D5740.
To evaluate the implementation of home telemonitoring and oxygen therapy in COVID-19 patients. Primary outcomes were safety, patient satisfaction, reduction of hospital stay, and cost-effectiveness.
Retrospective cohort study.
All COVID-19 patients who were discharged with home telemonitoring and oxygen therapy between June 1st and November 1st 2020 were included. Eligible patients had a maximum oxygen requirement of 2 liters per minute during the 24 hours prior to discharge with a minimal peripheral oxygen saturation of 94%. A mobile application for telemonitoring was used, which patients or relatives had to be able to use independently. Patient demographics, clinical parameters, data on telemonitoring and readmissions were extracted from the electronic patient records. A survey for patient satisfaction and a cost-effectiveness analysis were performed.
Out of 619 admissions, 49 patients were discharged with home telemonitoring and oxygen therapy. Median duration of home oxygen therapy was 11 days with a potential reduction in hospitalization of 616 days. Six patients were readmitted and were significantly more febrile on discharge (67% versus 14%, p=0.01) and had lower oxygenation (95%, (IQR 93-96) versus 96%, (IQR 95-97), p=0.02) with similar levels of oxygen administration. Patient satisfaction was high with a mean score of 5 to 6 on a scale measuring satisfaction from 1 to 7. Estimated total cost reduction was € 146.736.
This study shows that home telemonitoring and oxygen administration can be safely applied in COVID-19 patients resulting in a high patient satisfaction and reduction in hospital stay and costs.
评估居家远程监测和氧疗在新冠病毒疾病(COVID-19)患者中的实施情况。主要结局指标为安全性、患者满意度、住院时间缩短情况及成本效益。
回顾性队列研究。
纳入2020年6月1日至11月1日期间接受居家远程监测和氧疗出院的所有COVID-19患者。符合条件的患者在出院前24小时内最大吸氧需求为每分钟2升,外周血氧饱和度最低为94%。使用了一款用于远程监测的移动应用程序,患者或亲属必须能够独立使用。从电子病历中提取患者人口统计学资料、临床参数、远程监测数据和再入院数据。进行了患者满意度调查和成本效益分析。
在619例入院患者中,49例患者接受居家远程监测和氧疗后出院。居家氧疗的中位持续时间为11天,住院时间可能减少616天。6例患者再次入院,出院时发热情况显著更高(67%对14%,p = 0.01),且氧合情况更低(95%,四分位间距93 - 96对96%,四分位间距95 - 97,p = 0.02),吸氧水平相似。患者满意度较高,在1至7的满意度量表上平均得分为5至6分。估计总成本降低了146,736欧元。
本研究表明,居家远程监测和氧疗可安全应用于COVID-19患者,患者满意度高,住院时间和成本均降低。