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[新型冠状病毒肺炎患者的早期出院:阿姆斯特丹跨部门医疗保健项目评估]

[Early hospital discharge for patients with COVID-19: evaluation of the transmural healthcare program in Amsterdam].

作者信息

Hoolwerf Evert W, Zonneveld Stella J M, Nieuwkerk Pythia T, Bedert Maarten R D, Nijman Suzan F M, Posthuma Nynke, Reesink Herre J, Kanters E C Kees, Prins Jan M, van der Valk Marc

机构信息

Amsterdam UMC, locatie AMC, Amsterdam: Afd. Interne Geneeskunde en Infectiezieken.

Huisartsen ROAZ Noord Holland en Flevoland.

出版信息

Ned Tijdschr Geneeskd. 2021 Aug 3;165:D6168.

Abstract

OBJECTIVE

Evaluation of an early discharge program for COVID-19-patients who still required additional oxygen support, supervised by their own general practitioner (GP) in a home setting. We evaluated safety and gathered experiences from patients, caregivers and GPs.

DESIGN

Cohort study (prospective and retrospective inclusion) METHOD: Adult COVID-19-patients admitted to one of the three Amsterdam hospitals, the Netherlands, were eligible when clinically stable for at least 48 hours, with a minimum oxygen saturation of 94% and a maximum of 3 l/min oxygen support. Patients were included from 23-10-2020 to 26-03-2021.

RESULTS

We included 113 patients, of whom 40 retrospectively . Median age was 58 years and median length of hospital stay 8 days. Four patients (3.7%) were readmitted within 14 days after discharge. Median duration of oxygen support at home was 8 days. Almost no home visits were conducted by GPs, but contact by telephone was regular (median 6 times in 2 weeks). All stakeholders reported feeling safe, able and confident while delivering the necessary (self) care. The program was graded by patients and GPs with an 8 (on a scale of 1 to 10).

CONCLUSION

Early discharge for COVID-19-patients with a necessity for oxygen support, under supervision of the GP, is safe and was positively evaluated by all stakeholders involved.

摘要

目的

评估一项针对仍需额外吸氧支持的新冠病毒肺炎患者的早期出院计划,该计划由患者自己的全科医生在家庭环境中进行监督。我们评估了安全性,并收集了患者、护理人员和全科医生的经验。

设计

队列研究(前瞻性和回顾性纳入)

方法

荷兰阿姆斯特丹三家医院之一收治的成年新冠病毒肺炎患者,若临床稳定至少48小时,最低血氧饱和度为94%,最大吸氧支持为3升/分钟,则符合条件。患者于2020年10月23日至2021年3月26日纳入研究。

结果

我们纳入了113例患者,其中40例为回顾性纳入。中位年龄为58岁,中位住院时间为8天。4例患者(3.7%)在出院后14天内再次入院。在家吸氧支持的中位持续时间为8天。全科医生几乎没有进行家访,但电话联系很频繁(2周内中位6次)。所有利益相关者在提供必要的(自我)护理时都表示感到安全、有能力且自信。患者和全科医生对该计划的评分均为8分(满分10分)。

结论

在全科医生的监督下,对需要吸氧支持的新冠病毒肺炎患者进行早期出院是安全的,并且得到了所有相关利益者的积极评价。

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