Effectiveness of a telephone-based nursing intervention to reduce hospital utilization by COVID-19 patients.

ABSTRACT

OBJECTIVE: Determine the effectiveness of a COVID-19 remote monitoring and management program in reducing preventable hospital utilization. DESIGN: A retrospective cohort study utilizing data from electronic health records. SAMPLE Two hundred ninety-three patients who tested positive for COVID-19 at a drive-through testing site in Michigan. [Correction added on 11 April 2022, after first online publication In the preceding sentence, "Two hundred and ninety-third" has been corrected to "Two hundred ninety-three" in this version.] The intervention group, consisting of 139 patients, was compared to a control group of 154 patients. MEASUREMENTS The primary outcome was the 30-day probability of hospital utilization. The covariates included in the analysis were age, gender, tobacco use, body mass index (BMI), race, and ethnicity. INTERVENTION A nurse-led, telephone-based active management protocol for COVID-19 patients who were isolating at home. RESULTS: The intervention group had a non-statistically significant 42% reduction in risk of hospital utilization within 30 days of a positive COVID-19 test when compared to the control group (HR = 0.578, p-value .111, HR 95% CI [0.29, 1.13]). CONCLUSIONS: A nurse-led remote monitoring and management program for COVID-19 reduced the probability of 30-day hospital utilization. Although the findings were not statistically significant, the program yielded practical significance by reducing hospital utilization, in-person interaction, and the risk of infection for healthcare workers.