Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
BMJ Open. 2022 Jun 2;12(6):e061765. doi: 10.1136/bmjopen-2022-061765.
As the number of patients with COVID-19 increased, at-home care was introduced for the first time in South Korea. This study aimed to analyse the characteristics and outcomes of patients who were treated under at-home care.
DESIGN, SETTING AND PARTICIPANTS: This retrospective cohort study targeted patients under at-home care for COVID-19 in Yeongdeungpo-gu in Seoul, Korea, from 18 October 2021 to 12 December 2021. The public health centre selected eligible patients for at-home care and registered with our institution. Nurses monitored patients, and doctors decided to transfer healthcare facilities and release the quarantined patients according to their symptoms.
Patient characteristics during the course of at-home care.
A total of 1422 patients were enrolled and 9574 patient-days were managed. Most patients were aged ≥60 years (22.7% (n=323)), and 82.8% did not have underlying conditions. The median length of care for patients was 8 days (IQR: 5-10 days). During the study period, 986 (69.3%) patients were released from quarantine, 82 (5.8%) patients were transferred to facilities and 354 (24.9%) patients were still under at-home care at the end of the study period. The most common cause of transfer was sustained fever (n=30; 36.6%), followed by dyspnoea and desaturation (n=17; 20.7%). Factors associated with transfer were diabetes (OR: 3.591, 95% CI 1.488 to 8.665, p=0.004), pregnancy (OR: 5.839, 95% CI 1.035 to 32.935, p=0.046) and being presymptomatic at diagnosis (OR: 4.015, 95% CI 1.559 to 10.337, p=0.004).
There were no specific problems related to patient safety when operating at-home care. Patients with risk factors, such as diabetes, were more likely to be transferred to healthcare facilities. For safe at-home care, it is necessary to prepare for an appropriate response to the emergency.
随着 COVID-19 患者人数的增加，韩国首次引入了居家护理。本研究旨在分析接受居家护理的患者的特征和结局。
设计、地点和参与者：本回顾性队列研究针对的是 2021 年 10 月 18 日至 12 月 12 日期间在韩国首尔永登浦区接受 COVID-19 居家护理的患者。公共卫生中心选择符合条件的患者进行居家护理，并向我们机构登记。护士监测患者，医生根据症状决定将医疗设施转移和释放隔离患者。
居家护理过程中患者的特征。
共纳入 1422 名患者，管理了 9574 患者天。大多数患者年龄≥60 岁（22.7%（n=323）），82.8%无基础疾病。患者护理的中位数为 8 天（IQR：5-10 天）。在研究期间，986 名（69.3%）患者解除隔离，82 名（5.8%）患者转至设施，354 名（24.9%）患者在研究结束时仍接受居家护理。转院的最常见原因是持续发热（n=30；36.6%），其次是呼吸困难和血氧饱和度降低（n=17；20.7%）。与转院相关的因素包括糖尿病（OR：3.591，95%CI 1.488 至 8.665，p=0.004）、妊娠（OR：5.839，95%CI 1.035 至 32.935，p=0.046）和诊断前无症状（OR：4.015，95%CI 1.559 至 10.337，p=0.004）。
在实施居家护理时，没有与患者安全相关的特定问题。患有糖尿病等危险因素的患者更有可能被转至医疗机构。为了安全的居家护理，有必要为紧急情况做好适当的应对准备。
