COVID-19
Conditions
Keywords
COVID-19, Oxygen therapy, Early return
Brief summary
The René Dubos Hospital in Pontoise has set up a home discharge system for oxygen-requiring patients in collaboration with PRADO, a health insurance organization, or private providers. This organization coordinates the care to be implemented at home based on the city/hospital link. The coordinator of this organization was also in charge of scheduling a follow-up consultation between 7 and 14 days after hospital discharge. The aim of this study is to evaluate this new organization, both in terms of its impact on patient outcomes (survival and re-hospitalization rates) and on patients' experiences and satisfaction with their care.
Detailed description
The COVID-19 pandemic was responsible for an unprecedented hospital tension with multiple consequences (medical, economic, social...). The first scientific responses were found with unprecedented speed. Very quickly, innovative solutions and a complete reorganization of the health system were necessary to manage this crisis. In order to limit the number of patients hospitalized and/or the length of their hospitalization, most hospitals quickly set up systems to organize the early return of patients to their homes on oxygen. Studies evaluating telemedicine as a tool for monitoring oxygen-requiring patients at home have shown that it is effective and safe for monitoring these patients. Another retrospective study estimated the 30-day rehospitalization rate for patients with SARS-CoV-2 pneumonia after return home on oxygen with telephone monitoring by a nurse to be 8.5% (95% confidence interval, 6.2%-10.7%) and all-cause mortality to be 1.3% (95% confidence interval, 0.6%-2.5%). The René Dubos Hospital in Pontoise has set up a home discharge system for oxygen-requiring patients in collaboration with PRADO, a health insurance organization, and a private provider. These organizations coordinate the care to be implemented at home based on the city/hospital link (oxygen provider, private nurse for the injection of anticoagulants and sometimes insulin and monitoring of vital parameters). These organizations were also in charge of scheduling a follow-up consultation between 7 and 14 days after hospital discharge, with the attending physician or, failing that, in the infectious diseases department of the Pontoise Hospital.
Interventions
Evaluation of the outcome of Covid-19 patients discharged home on oxygen therapy
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients over 18 years of age * Patients with virologically proven COVID 19 (positive Polymerase Chain Reaction or antigenic test) or based on clinical and radiological evidence * Patients discharged from hospital or from the emergency room on oxygen between 1 and 5L at the time of discharge * Organization of discharge by a service provider (PRADO or private)
Exclusion criteria
* Patients discharged from the intensive care unit * Oxygen-requiring patients \> 5 Liters
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Description of the evolution of patients with COVID-19 who benefited from an early return home on oxygen organized by the PRADO or a private provider | At 30 days of hospital discharge (D30) | Assessment of mortality (all causes) at 30 days of hospital discharge (D30) : number of died patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of the risk of early re-hospitalization of patients following their return home | At 7 days from hospital discharge (D7) | Number of re-hospitalizations at 7 days from hospital discharge (D7) |
| Assessment of patients' satisfaction with their care and return home | At the end of the study, an average of 10 month | Evaluation of patients'satisfaction : Satisfaction questionnaire contains 5 questions : For Q1, patient answer : Very satisfied, Satisfied, Neither satisfied or unsatisfied, Unsatisfied or Very unsatisfied For Q2, patient answer : Very confident, Confident, Neither confident or anguished, Anguished or Very anguished For Q3, patient answer : Yes, I don't know or No For Q4 and Q5, patient answer : Yes or No |
Countries
France