Acute home-based management initiatives for COVID-19 patients needing oxygen: observational study reporting mortality and hospital admission outcomes

Abstract

Objective Acute home-based management for COVID-19 patients requiring oxygen therapy was introduced during the pandemic as an alternative to in-hospital care and early hospital discharge. This study aims to synthesize clinical course data, health care resource use data, and mortality rates of patients who received acute home-based management during the pandemic in the Netherlands. Method Retrospective cohort study of patients receiving acute home-based management including oxygen therapy for COVID-19 across five Dutch regional initiatives between December 2020 and January 2022. The general practitioner (GP) provided medical care in three initiatives, whereas two initiatives were hospital-led. Results Data were collected for 92 patients (mean age 63 [standard deviation (SD) 13] years, 54% male). The median number of days of oxygen therapy and remote monitoring were 8.5 (IQR: 6-13) and 14 (IQR: 9-18), respectively. In total, 17 patients (18%) required hospital admission following acute home-based management, of whom six died during admission. No patients died at home. A median of 1 (interquartile rage [IQR]: 0-4) GP consultation took place per patient during home-based management; 64% via phone and 31% home visits. In hospital-led initiatives, the GP was consulted at least once in 46% of patients. Conclusion Acute home-based management of COVID-19 patients requiring oxygen therapy resulted in avoidance of hospital admission in the majority of patients, however at the price of a higher workload for GPs.