van Hattem Nicoline E, Mijnsbergen Niels J, van Os Hendrikus J A, Mertens Bart A, Eekhof Just A H, Chavannes Niels H, Atsma Douwe E, Bonten Tobias N
Department of Public Health and Primary Care, Leiden University Medical Centre, 2333 ZA, Leiden, The Netherlands.
National eHealth Living Lab (NeLL), Leiden University Medical Centre, The Netherlands.
Fam Pract. 2025 Feb 7;42(2). doi: 10.1093/fampra/cmae045.
At the onset of the COVID-19 pandemic, the pressure on hospitals increased tremendously. To alleviate this pressure, a remote patient monitoring system called the COVID Box was developed and implemented in primary care. The aim was to assess whether the COVID Box in primary care could reduce emergency department (ED) referrals due to a COVID-19 infection. A matched cohort study was performed between December 2020 and June 2021. Patients with a COVID-19 infection in need of intensive monitoring based on the clinical judgement of their own general practitioner received the COVID Box in primary care combining home monitoring of vital parameters with daily video consultations. The control group was retrospectively matched by propensity score matching. We conducted a subgroup analysis in higher-risk patients with oxygen saturation measurements, considering oxygen saturation as a critical parameter for assessing the risk of a complicated infection. We included 205 patients, of whom 41 patients were monitored with the COVID Box (mean age 70 and 53.7% male) and 164 in the control group (mean age 71.5 and 53% male). No difference was found in ED referrals between the intervention and control groups in our primary analysis. In the subgroup analysis, we found a nonsignificant trend that remote monitoring could reduce the ED referrals. While the overall study found comparable ED referrals between groups, the subgroup analysis suggested a promising prospect in reducing ED referrals due to remote monitoring of higher-risk patients with acute respiratory disease in primary care.
在新冠疫情初期，医院面临的压力急剧增加。为缓解这一压力，一种名为“新冠盒子”的远程患者监测系统在基层医疗中得以开发和应用。其目的是评估基层医疗中的“新冠盒子”能否减少因新冠病毒感染导致的急诊科（ED）转诊。在2020年12月至2021年6月期间进行了一项匹配队列研究。根据其自身全科医生的临床判断，需要进行强化监测的新冠病毒感染患者在基层医疗中使用“新冠盒子”，该系统将生命体征参数的居家监测与每日视频会诊相结合。对照组通过倾向得分匹配进行回顾性匹配。我们对进行了血氧饱和度测量的高危患者进行了亚组分析，将血氧饱和度视为评估复杂感染风险的关键参数。我们纳入了205名患者，其中41名患者使用“新冠盒子”进行监测（平均年龄70岁，男性占53.7%），164名患者在对照组（平均年龄71.5岁，男性占53%）。在我们的主要分析中，干预组和对照组之间在急诊科转诊方面未发现差异。在亚组分析中，我们发现远程监测可减少急诊科转诊这一趋势不显著。虽然总体研究发现两组之间的急诊科转诊情况相当，但亚组分析表明，在基层医疗中对患有急性呼吸道疾病的高危患者进行远程监测以减少急诊科转诊方面具有广阔前景。
