Is home-based management feasible for COVID-19 patients requiring oxygen therapy? A participatory action study and cost analysis

Vollständiger Abstract

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Objectives To explore feasibility and estimate cost of a home-based intervention for COVID-19 patients requiring oxygen therapy. Design and setting Participatory action study embedded in a regional collaborative healthcare network. Participants 13 patients were included (77% female; mean age 68 years, SD 18.2). Intervention A previously designed intervention was piloted and iteratively evaluated in a multidisciplinary expert panel using a participatory action research approach. Primary and secondary outcome measures We scrutinised clinical course data and monitored adverse events. Feasibility was assessed using 12 key elements related to (1) communication, (2) logistics, (3) treatment and remote monitoring and (4) adverse events. In an explorative cost analysis, intervention costs were compared with hospital admission costs as the reference. Results Home-based management lasted for 7 days (SD 3.4) on average, with 4 days (SD 2.6) oxygen therapy. No intervention-related adverse events occurred. Main challenges were related to interprofessional communication, nursing care organisation and timely delivery of oxygen concentrators. Excluding costs for setting up the intervention, costs were estimated at €1124 per patient and this was mainly driven by costs on the first day. Compared with hospital admission, the cost-saving potential is estimated at €1087 to €2850 per patient. Conclusions An acute home-based care intervention embedded in a regional collaborative care network for patients with acute respiratory tract infections requiring oxygen therapy seems feasible and is potentially cost-saving. Trial registration number The Dutch Trial Register CCMO: NL77421.041.21; OMON Register: NL-OMON22655.