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Home-based initiatives for acute management of COVID-19 patients needing oxygen: differences across The Netherlands.

Authors :
Boeijen, Josi A.
van de Pol, Alma C.
van Uum, Rick T.
Smit, Karin
Ahmad, Abeer
van Rijswijk, Eric
van Apeldoorn, Marjan J.
van Thiel, Eric
de Graaf, Netty
Menkveld, R. Michiel
Mantingh, Martijn R.
Geertman, Silke
Couzijn, Nicolette
van Groenendael, Leon
Schers, Henk
Bont, Jettie
Bonten, Tobias N.
Rutten, Frans H.
Zwart, Dorien L. M.
Source :
BMC Health Services Research; 11/15/2023, Vol. 23 Issue 1, p1-10, 10p
Publication Year :
2023

Abstract

Objective: During the COVID-19 pandemic new collaborative-care initiatives were developed for treating and monitoring COVID-19 patients with oxygen at home. Aim was to provide a structured overview focused on differences and similarities of initiatives of acute home-based management in the Netherlands. Methods: Initiatives were eligible for evaluation if (i) COVID-19 patients received oxygen treatment at home; (ii) patients received structured remote monitoring; (iii) it was not an 'early hospital discharge' program; (iv) at least one patient was included. Protocols were screened, and additional information was obtained from involved physicians. Design choices were categorised into: eligible patient group, organization medical care, remote monitoring, nursing care, and devices used. Results: Nine initiatives were screened for eligibility; five were included. Three initiatives included low-risk patients and two were designed specifically for frail patients. Emergency department (ED) visit for an initial diagnostic work-up and evaluation was mandatory in three initiatives before starting home management. Medical responsibility was either assigned to the general practitioner or hospital specialist, most often pulmonologist or internist. Pulse-oximetry was used in all initiatives, with additional monitoring of heart rate and respiratory rate in three initiatives. Remote monitoring staff's qualification and authority varied, and organization and logistics were covered by persons with various backgrounds. All initiatives offered remote monitoring via an application, two also offered a paper diary option. Conclusions: We observed differences in the organization of interprofessional collaboration for acute home management of hypoxemic COVID-19 patients. All initiatives used pulse-oximetry and an app for remote monitoring. Our overview may be of help to healthcare providers and organizations to set up and implement similar acute home management initiatives for critical episodes of COVID-19 (or other acute disorders) that would otherwise require hospital care. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14726963
Volume :
23
Issue :
1
Database :
Complementary Index
Journal :
BMC Health Services Research
Publication Type :
Academic Journal
Accession number :
173624268
Full Text :
https://doi.org/10.1186/s12913-023-10191-6