ABSTRACT
Introduction: Recently, this journal published a study on the experiences of 49 stable Covid-19 patients who were discharged early from hospital. These patients self-administered oxygen at home and were supervised remotely by a pulmonologist or lung nurse. In October 2020, a project started in Amsterdam in which Covid-19 patients were discharged early, received oxygen supplementation at home and were supervised by their own GP. We report the safety of this approach and describe the expectations beforehand and satisfaction afterwards of all involved. MethodAdult patients admitted to Amsterdam UMC, OLVG or BovenIJ hospital because of covid-19 were eligible for early discharge if they were clinically stable for at least 48 hours and had an oxygen saturation of 94% on oxygen therapy at 3 l/min (figure). Before discharge, patients were taught how to use a pulse oximeter (ihealth P03M, CE/FDA certified) and oxygen equipment. Treatment with dexamethasone and thrombosis prophylaxis were continued in accordance with current treatment guidelines as long as there was an indication. The participants were transferred verbally and in writing from the hospital to their own GP who then took over the supervision. In the period January 18-March 26, 2021, patients could be prospectively included in this evaluation. All patients discharged from October 23, 2020 to January 18, 2021 were retrospectively included. We collected clinical data from the patients and completed questionnaires among patients, general practitioners and caregivers, before hospital discharge and 14 days after.
ABSTRACT
OBJECTIVE: Evaluation of an early discharge program for COVID-19-patients who still required additional oxygen support, supervised by their own general practitioner (GP) in a home setting. We evaluated safety and gathered experiences from patients, caregivers and GPs. DESIGN: Cohort study (prospective and retrospective inclusion) RESULTS: We included 113 patients, of whom 40 retrospectively . Median age was 58 years and median length of hospital stay 8 days. Four patients (3.7%) were readmitted within 14 days after discharge. Median duration of oxygen support at home was 8 days. Almost no home visits were conducted by GPs, but contact by telephone was regular (median 6 times in 2 weeks). All stakeholders reported feeling safe, able and confident while delivering the necessary (self) care. The program was graded by patients and GPs with an 8 (on a scale of 1 to 10). CONCLUSION: Early discharge for COVID-19-patients with a necessity for oxygen support, under supervision of the GP, is safe and was positively evaluated by all stakeholders involved.