Use of a Telemedicine Risk Assessment Tool to Predict the Risk of Hospitalization of 496 Outpatients with COVID-19: Retrospective Analysis
JMIR Public Health Surveill. 2021 Feb 26. doi: 10.2196/25075. Online ahead of print.
BACKGROUND: Risk assessment of patients with acute coronavirus disease 2019 (COVID-19) in a telemedicine context is not well described. In the setting of large numbers of patients, a risk assessment tool may guide resource allocation not only for patient care but also for maximum healthcare and public health benefit.
OBJECTIVE: Determine whether a COVID-19 telemedicine risk assessment tool accurately predicts hospitalizations.
METHODS: We conducted a retrospective study of a COVID-19 telemedicine home monitoring program serving healthcare workers and the community in Atlanta, Georgia, enrollment from March 24 to May 26, 2020 (final call range March 27 to June 19, 2020). All patients were assessed by medical providers using an institutional COVID-19 risk assessment tool designating patients as “Tier 1” (low risk for hospitalization), “Tier 2” (intermediate risk), or “Tier 3” (high risk). Patients were followed with regular telephone calls to an endpoint of improvement or hospitalization. Using survival analysis by Cox regression with days to hospitalization as metric, we analyzed the performance of the risk tiers and explored individual patient factors associated with risk of hospitalization.
RESULTS: Providers using the risk-assessment rubric assigned 496 outpatients to tiers: Tier 1, 237 (47.8%); Tier 2, 185 (37.3%); Tier 3, 74 (14.9%). Subsequent hospitalizations numbered 3 (1%) for Tier 1, 15 (7%) for Tier 2, and 17 (23%) for Tier 3. From a Cox regression model with age ≥ 60, gender, and reported obesity as covariates, the adjusted hazard ratios for hospitalization using Tier 1 as reference were: Tier 2 HR=3.74 (95% CI, 1.06-13.27; p=.041); Tier 3 HR=10.87 (95% CI, 3.09-38.27; p<.001).
CONCLUSIONS: A telemedicine risk assessment tool prospectively applied to an outpatient population with COVID-19 identified populations with low, intermediate, and high risk of hospitalization.
PMID:33667174 | DOI:10.2196/25075
Powered by WPeMatico
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.