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基于电话的护理干预对降低 COVID-19 患者住院利用率的效果。

Effectiveness of a telephone-based nursing intervention to reduce hospital utilization by COVID-19 patients.

机构信息

Preventive Medicine Residency Program, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

Research Statistician, Research and Support Systems, Henry Ford Allegiance Health, Jackson, Michigan, USA.

出版信息

Public Health Nurs. 2022 Sep;39(5):940-948. doi: 10.1111/phn.13074. Epub 2022 Mar 25.

Abstract

OBJECTIVE

Determine the effectiveness of a COVID-19 remote monitoring and management program in reducing preventable hospital utilization.

DESIGN

A retrospective cohort study utilizing data from electronic health records.

SAMPLE

Two hundred ninety-three patients who tested positive for COVID-19 at a drive-through testing site in Michigan. [Correction added on 11 April 2022, after first online publication: In the preceding sentence, "Two hundred and ninety-third" has been corrected to "Two hundred ninety-three" in this version.] The intervention group, consisting of 139 patients, was compared to a control group of 154 patients.

MEASUREMENTS

The primary outcome was the 30-day probability of hospital utilization. The covariates included in the analysis were age, gender, tobacco use, body mass index (BMI), race, and ethnicity.

INTERVENTION

A nurse-led, telephone-based active management protocol for COVID-19 patients who were isolating at home.

RESULTS

The intervention group had a non-statistically significant 42% reduction in risk of hospital utilization within 30 days of a positive COVID-19 test when compared to the control group (HR = 0.578, p-value .111, HR 95% CI [0.29, 1.13]).

CONCLUSIONS

A nurse-led remote monitoring and management program for COVID-19 reduced the probability of 30-day hospital utilization. Although the findings were not statistically significant, the program yielded practical significance by reducing hospital utilization, in-person interaction, and the risk of infection for healthcare workers.

摘要

目的

确定 COVID-19 远程监测和管理计划在降低可预防的医院利用方面的有效性。

设计

利用电子健康记录数据进行的回顾性队列研究。

样本

密歇根州一个免下车检测点检测出 COVID-19 呈阳性的 293 名患者。[2022 年 4 月 11 日更正:在前一句中,“Two hundred and ninety-third”已更正为“Two hundred ninety-three”。]干预组由 139 名患者组成,与对照组 154 名患者进行比较。

测量

主要结果是 30 天内住院利用的概率。分析中纳入的协变量包括年龄、性别、吸烟、体重指数(BMI)、种族和民族。

干预措施

一种针对在家隔离的 COVID-19 患者的护士主导、电话为基础的主动管理方案。

结果

与对照组相比,干预组在 COVID-19 检测呈阳性后 30 天内住院利用的风险降低了 42%,但无统计学意义(HR = 0.578,p 值.111,HR 95%CI [0.29,1.13])。

结论

针对 COVID-19 的护士主导的远程监测和管理计划降低了 30 天内住院利用的可能性。尽管结果无统计学意义,但该计划通过减少医院利用、面对面互动以及医护人员感染的风险,产生了实际意义。

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