Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jan 26, 2024)
Date Submitted: Dec 12, 2022
Open Peer Review Period: Dec 12, 2022 - Feb 6, 2023
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A Matched, Retrospective Comparative Effectiveness Study of Home-based versus Inpatient Hospital Care for Acutely Ill COVID-19 Patients
ABSTRACT
Background:
Hospital at Home (HaH) programs have been shown to be an effective care delivery model in diverse settings. Comparative effectiveness evaluations between HaH and traditional inpatient care for COVID-19 patients are limited.
Objective:
To test the effectiveness of care provided through Atrium Health-HaH compared to inpatient hospitalization for acutely ill patients with COVID-19.
Methods:
Retrospective matched sample comparative effectiveness study of 116 patients who presented to an emergency department and tested positive for COVID-19 at Atrium Health, a large integrated health care organization in the southeastern United States. Patients who were subsequently hospitalized between May 8 and June 25, 2020 (n = 58) were included in the control group, patients admitted to AH-HaH between July 15 and September 31, 2020 (n = 58) were included in the treatment condition. The primary outcome was 30-day composite of severe illness and death, indexed by the WHO illness severity scale. Patient demographic characteristics, comorbidities and hospital outcomes were collected from electronic health records.
Results:
30-days post discharge, the number of patients who experienced severe illness or death was equivalent (n = 11/group; strata adjusted OR 1.0, 95% CI 0.37-2.69).
Conclusions:
AH-HaH provides a feasible and efficacious alternative to traditional inpatient treatment for acutely ill patients with COVID-19.
Citation
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