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- Title
An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19.
- Authors
Kilaru, Austin S.; Porges, Stefanie B.; Grossman, Lindsay; Delgado, M. Kit; Morgan, Anna U.; Chaiyachati, Krisda H.; Asch, David A.; Greysen, S. Ryan; Lockwood, Amy C.; Hemmert, Keith C.; McGinley, Susan
- Abstract
OBJECTIVES: Strategies to maintain hospital capacity during the COVID-19 pandemic included reducing hospital length of stay (LOS) for infected patients. We sought to evaluate the association between LOS and enrollment in the COVID Accelerated Care Pathway, which consisted of a hospital observation protocol and postdischarge automated text message--based monitoring. STUDY DESIGN: Retrospective matched cohort study of patients hospitalized from December 14, 2020, to January 31, 2021. METHODS: Participants were patients who presented to the emergency department with acute infection due to COVID-19, required hospitalization, and met pathway inclusion criteria. Participants were compared with a propensity score--matched cohort of patients with COVID-19 admitted to the same hospital during the 7 weeks preceding and following pathway implementation. RESULTS: There were 44 patients in the intervention group and 83 patients in the propensity score--matched cohort. The mean (SD) hospital LOS for patients in the intervention group was 1.7 (2.6) days compared with 3.9 (2.3) days for patients in the matched cohort (difference, -2.2 days; 95% CI, -3.3 to -1.1). In the intervention group, 2 patients (5%; 95% CI, 0%-15%) were rehospitalized within 14 days compared with 8 (10%; 95% CI, 4%-17%) in the matched cohort. CONCLUSIONS: Patients with COVID-19 who were managed through an accelerated hospital observation protocol and postdischarge monitoring service had reduced hospital LOS compared with patients receiving standard care. Hospital preparedness for future public health emergencies may involve the design of pathways that reduce the time that patients spend in the hospital, lower cost, and ensure continued recovery upon discharge.
- Subjects
LENGTH of stay in hospitals; PATIENT aftercare; VIRAL pneumonia; HOSPITAL observation units; COVID-19; HOSPITAL emergency services; CONFIDENCE intervals; ACADEMIC medical centers; CHEST X rays; FEVER; AGE distribution; MULTIPLE regression analysis; HOME care services; RETROSPECTIVE studies; PATIENTS; PATIENT readmissions; ACQUISITION of data; OXYGEN saturation; HEALTH outcome assessment; PATIENT monitoring; MEDICAL protocols; SEVERITY of illness index; HOSPITAL admission &; discharge; COMPARATIVE studies; URBAN hospitals; AUTOMATION; EMERGENCY medical services; DESCRIPTIVE statistics; MEDICAL records; OXYGEN therapy; CRITICAL care medicine; TIME series analysis; TEXT messages; DATA analysis software; SENSITIVITY &; specificity (Statistics); LONGITUDINAL method; SECONDARY analysis
- Publication
American Journal of Managed Care, 2022, Vol 28, Issue 6, p262
- ISSN
1088-0224
- Publication type
Article
- DOI
10.37765/ajmc.2022.88789