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针对急性住院的新冠肺炎肺炎患者的出院后远程患者监测项目的实施及其对住院时间的影响。

Implementation and impact on length of stay of a post-discharge remote patient monitoring program for acutely hospitalized COVID-19 pneumonia patients.

作者信息

Kuo Sherwin, Aledia Anna, O'Connell Ryan, Rudkin Scott, Dangodara Amish A, Amin Alpesh N

机构信息

Department of Medicine/Hospital Medicine, UC Irvine Health, Orange, California, USA.

Clinical Informatics Program, UC Irvine Health, Orange, California, USA.

出版信息

JAMIA Open. 2022 Jul 1;5(3):ooac060. doi: 10.1093/jamiaopen/ooac060. eCollection 2022 Oct.

DOI:10.1093/jamiaopen/ooac060
PMID:35879961
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9278264/
Abstract

OBJECTIVE

In order to manage COVID-19 patient population and bed capacity issues, remote patient monitoring (RPM) is a strategy used to transition patients from inpatients to home. We describe our RPM implementation process for post-acute care COVID-19 pneumonia patients. We also evaluate the impact of RPM on patient outcomes, including hospital length of stay (LOS), post-discharge Emergency Department (ED) visits, and hospital readmission.

MATERIALS AND METHODS

We utilized a cloud-based RPM platform (Vivify Health) and a nurse-monitoring service (Global Medical Response) to enroll COVID-19 patients who required oxygen supplementation after hospital discharge. We evaluated patient participation, biometric alerts, and provider communication. We also assessed the program's impact by comparing RPM patient outcomes with a retrospective cohort of Control patients who similarly required oxygen supplementation after discharge but were not referred to the RPM program. Statistical analyses were performed to evaluate the 2 groups' demographic characteristics, hospital LOS, and readmission rates.

RESULTS

The RPM program enrolled 75 patients with respondents of a post-participation survey reporting high satisfaction with the program. Compared to the Control group ( = 150), which had similar demographics and baseline characteristics, the RPM group was associated with shorter hospital LOS (median 4.8 vs 6.1 days; =.03) without adversely impacting return to the ED or readmission.

CONCLUSION

We implemented a RPM program for post-acute discharged COVID-19 patients requiring oxygen supplementation. Our RPM program resulted in a shorter hospital LOS without adversely impacting quality outcomes for readmission rates and improved healthcare utilization by reducing the average LOS.

摘要

目的

为了应对新冠病毒疾病(COVID-19)患者数量和床位容量问题,远程患者监测(RPM)是一种用于将患者从住院转为居家治疗的策略。我们描述了针对急性后护理COVID-19肺炎患者的RPM实施过程。我们还评估了RPM对患者结局的影响,包括住院时间(LOS)、出院后急诊室(ED)就诊情况以及再次入院情况。

材料与方法

我们利用基于云的RPM平台(Vivify Health)和护士监测服务(Global Medical Response),纳入出院后仍需吸氧的COVID-19患者。我们评估了患者参与情况、生物特征警报以及与医护人员的沟通。我们还通过将RPM患者的结局与一组回顾性对照患者进行比较,评估了该项目的影响。这些对照患者同样在出院后需要吸氧,但未被纳入RPM项目。进行了统计分析,以评估两组的人口统计学特征、住院时间和再入院率。

结果

RPM项目纳入了75名患者,参与后调查的受访者对该项目满意度很高。与具有相似人口统计学和基线特征的对照组(n = 150)相比,RPM组的住院时间更短(中位数4.8天对6.1天;P =.03),且对再次前往急诊室或再次入院没有不利影响。

结论

我们为出院后仍需吸氧的急性后COVID-19患者实施了RPM项目。我们的RPM项目缩短了住院时间,且对再入院率这一质量结局没有不利影响,并通过缩短平均住院时间提高了医疗资源利用率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15dc/9308451/ca236ef01e1f/ooac060f6.jpg
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