SHM Converge Scientific Abstract ePoster Gallery-Acute Care at Home: A Hospitalization Alternative for Patients Wtih Acute Covid-19 Illness

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The document describes an Acute Care at Home (ACAH) program implemented as an alternative to traditional hospitalization for patients with acute COVID-19 illness. The program was developed in response to healthcare resource constraints worsened by the COVID-19 pandemic, including shortages of hospital beds, ventilators, and staff.<br /><br />Patients were selected for ACAH through risk stratification based on oxygen needs, illness timing, and comorbidities. Eligible patients met inpatient criteria, required up to 4 liters of oxygen, and had insurance approval. Care in the home mirrored hospital-level services, including 24/7 hospitalist telemedicine support, bedside visits from nurse practitioners, paramedics, and nurses, plus respiratory therapy, radiology, lab services, pulse oximetry monitoring, and medications. Clear protocols were in place for transfer to a hospital if patients worsened.<br /><br />Between October 1, 2020 and November 13, 2021, 117 patients were enrolled. Of these, 103 were successfully discharged from ACAH. The average length of stay was 4.8 days. Fourteen patients required transfer to a hospital; most of these patients later recovered enough to go home, while one died after transfer. One additional patient discharged from ACAH was later readmitted and died during a subsequent hospitalization. The patients who died had significant immunocompromising conditions.<br /><br />The authors conclude that ACAH can provide care comparable to traditional hospitalization for COVID-19 patients with mild oxygen requirements, while preserving hospital capacity for sicker patients. However, they caution that immunocompromised patients may need closer consideration for in-hospital treatment even if their oxygen needs are limited.

Asset Subtitle

Brian Perkins

Meta Tag

Author List Benjamin Russell, Brian Perkins, Caitlyn Hollingshead, Evan Brochin, Joel Kammeyer, Sara Seegert

Category Research

Concept Home-Based Acute Care

Concept COVID-19

Concept Patient Selection Criteria

Concept Hospital-Equivalent Care

Concept Risk Stratification

Distinguished Non-Finalist

Presenter Organization ProMedica Acute Care at Home

Presenting Author Brian Perkins

Track Technology in Hospital Medicine

Keywords

Acute Care at Home

ACAH

COVID-19

hospitalization alternative

oxygen therapy

telemedicine

risk stratification

hospital capacity

immunocompromised patients

home-based care

Home-Based Acute Care

COVID-19

Patient Selection Criteria

Hospital-Equivalent Care

Risk Stratification