PT  - JOURNAL ARTICLE
AU  - Michael Boniface
AU  - Daniel Burns
AU  - Christopher Duckworth
AU  - Mazen Ahmed
AU  - Franklin Duruiheoma
AU  - Htwe Armitage
AU  - Naomi Ratcliffe
AU  - John Duffy
AU  - Caroline O’Keeffe
AU  - Matt Inada-Kim
TI  - COVID-19 Oximetry @home: evaluation of patient outcomes
AID  - 10.1136/bmjoq-2021-001584
DP  - 2022 Mar 01
TA  - BMJ Open Quality
PG  - e001584
VI  - 11
IP  - 1
4099  - http://bmjopenquality.bmj.com/content/11/1/e001584.short
4100  - http://bmjopenquality.bmj.com/content/11/1/e001584.full
SO  - BMJ Open Qual2022 Mar 01; 11
AB  - Background COVID-19 has placed unprecedented demands on hospitals. A clinical service, COVID-19 Oximetry @home (CO@h) was launched in November 2020 to support remote monitoring of COVID-19 patients in the community. Remote monitoring through CO@h aims to identify early patient deterioration and provide timely escalation for cases of silent hypoxia, while reducing the burden on secondary care.Methods We conducted a retrospective service evaluation of COVID-19 patients onboarded to CO@h from November 2020 to March 2021 in the North Hampshire (UK) community led service (a collaboration of 15 General Practitioner (GP) practices covering 230 000 people). We have compared outcomes for patients admitted to Basingstoke and North Hampshire Hospital who were CO@h patients (COVID-19 patients with home monitoring of oxygen saturation (SpO2; n=115), with non-CO@h patients (those directly admitted without being monitored by CO@h (n=633)). Crude and adjusted OR analysis was performed to evaluate the effects of CO@h on patient outcomes of 30-day mortality, Intensive care unit (ICU) admission and hospital length of stay greater than 3, 7, 14 and 28 days.Results Adjusted ORs for CO@h show an association with a reduction for several adverse patient outcome: 30-day hospital mortality (p<0.001, OR 0.21, 95% CI 0.08 to 0.47), hospital length of stay larger than 3 days (p<0.05, OR 0.62, 95% CI 0.39 to 1.00), 7 days (p<0.001, OR 0.35, 95% CI 0.22 to 0.54), 14 days (p<0.001, OR 0.22 95% CI, 0.11 to 0.41), and 28 days (p<0.05, OR 0.21, 95% CI 0.05 to 0.59). No significant reduction ICU admission was observed (p>0.05, OR 0.43, 95% CI 0.15 to 1.04). Within 30 days of hospital admission, there were no hospital readmissions for those on the CO@h service as opposed to 8.7% readmissions for those not on the service.Conclusions We have demonstrated a significant association between CO@h and better patient outcomes; most notably a reduction in the odds of hospital lengths of stays longer than 7, 14 and 28 days and 30-day hospital mortality.Data are available upon request.