Outcomes in novel hospital-at-home model for patients with COVID-19: a multicentre retrospective cohort study

Area of Science:

• Healthcare Management
• Infectious Disease Management
• Primary Care Innovation

Background:

• Hospital-at-home (HaH) care is an alternative to inpatient treatment for COVID-19 patients.
• Existing HaH models are hospital-led, increasing hospital burden.
• A novel HaH model organized by primary care clinics was developed to alleviate hospital strain.

Purpose of the Study:

• To evaluate the effectiveness of a primary care-led hospital-at-home (HaH) model for COVID-19 patients.
• To assess the ability of the HaH model to triage patients needing hospitalization.
• To determine the outcomes for COVID-19 patients managed under this novel HaH care model.

Main Methods:

• A multicentre retrospective cohort study of COVID-19 patients receiving HaH care from January to March 2022.
• Inclusion criteria: COVID-19 patients not triaged for hospitalization by the designated city Health Center.
• Primary outcome: Medical care beyond HaH (consultation, hospitalization, or death within 30 days).

Main Results:

• Out of 382 eligible patients, 34 (9%) required immediate hospitalization.
• Of the 348 patients followed up at home, 37 (11%) experienced the primary outcome; no deaths occurred.
• Obesity, fever, and gastrointestinal symptoms were independent risk factors for requiring further medical care. 37% managed online only, 50% required one home visit.

Conclusions:

• The primary care-led HaH model successfully triaged COVID-19 patients needing hospitalization without hospital involvement.
• The model effectively managed the majority of COVID-19 patients at home, demonstrating its efficiency.
• This approach reduces the burden on hospitals while providing effective care for COVID-19 patients.