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针对 COVID-19 门诊患者的虚拟护理计划:一项可行性研究。

A virtual care program for outpatients diagnosed with COVID-19: a feasibility study.

机构信息

Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont

Department of Medicine (Lam, Sehgal, Andany, Mubareka, Simor, Leis, Daneman, Chan), University of Toronto; Division of Infectious Diseases (Lam, Andany, Mubareka, Simor, Leis, Daneman, Chan), Sunnybrook Health Sciences Centre; Toronto Public Health (Ozaldin), Toronto, Ont.

出版信息

CMAJ Open. 2020 May 23;8(2):E407-E413. doi: 10.9778/cmajo.20200069. Print 2020 Apr-Jun.

Abstract

BACKGROUND

In patients who are discharged home to self-isolate while coronavirus disease 2019 (COVID-19) test results are pending, there is no formal method for physician assessments or counselling to occur if the result returns positive. Our aim was to develop and test the feasibility of a virtual care program for self-isolating outpatients diagnosed with COVID-19.

METHODS

In preparation for this gap in health care, the COVID-19 Expansion to Outpatients (COVIDEO) program was developed at the Sunnybrook Health Sciences Centre, Toronto, Ontario, to provide ongoing care for outpatients diagnosed with COVID-19. As part of a feasibility study, we describe our experiences with the first 50 patients managed using this program from its inception (Mar. 1, 2020) until Mar. 27, 2020.

RESULTS

All 50 people who tested positive for COVID-19 at the Sunnybrook Health Sciences Centre and were discharged home to self-isolation during the study period were assessed through the COVIDEO program. Thirty-two patients (64%) were assessed via the Ontario Telemedicine Network virtual care platform, and the remainder by telephone. The median time from viral swab collection to first COVIDEO program assessment was 2 (interquartile range [IQR] 1-2) days. Among the 26 patients for whom further follow-up care through the COVIDEO program was discontinued by the end of March 2020, the median duration of virtual care was 12.5 (IQR 8.75-16) days. During the study period, 6 patients required transfer to hospital for assessment, of whom 4 required admission.

INTERPRETATION

We have shown that a virtual care program can be used in the management of outpatients diagnosed with COVID-19. Further studies evaluating its sustainability and impact on health outcomes are underway.

摘要

背景

在等待 2019 冠状病毒病(COVID-19)检测结果期间,患者出院回家进行自我隔离,如果检测结果呈阳性,目前尚无法为患者提供正式的医生评估或咨询服务。我们的目标是开发并测试一种针对自我隔离的 COVID-19 门诊患者的虚拟护理计划,并评估其可行性。

方法

为了弥补这一医疗空白,安大略省多伦多市桑尼布鲁克卫生科学中心(Sunnybrook Health Sciences Centre)开发了 COVID-19 拓展门诊项目(COVIDEO),为确诊 COVID-19 的门诊患者提供持续护理。作为一项可行性研究的一部分,我们介绍了自 2020 年 3 月 1 日(COVIDEO 项目启动)至 2020 年 3 月 27 日期间,使用该项目管理的前 50 名患者的经验。

结果

在研究期间,桑尼布鲁克卫生科学中心所有经检测 COVID-19 阳性并出院回家自我隔离的患者都通过 COVIDEO 项目进行了评估。32 名患者(64%)通过安大略省远程医疗网络虚拟护理平台进行评估,其余患者通过电话进行评估。从采集病毒拭子到首次 COVIDEO 项目评估的中位数时间为 2(四分位距[IQR] 1-2)天。在 2020 年 3 月底停止通过 COVIDEO 项目进行进一步随访的 26 名患者中,虚拟护理的中位数持续时间为 12.5(IQR 8.75-16)天。在研究期间,有 6 名患者需要转至医院评估,其中 4 名需要住院。

结论

我们已经证明,虚拟护理计划可用于管理确诊 COVID-19 的门诊患者。目前正在进行进一步的研究,以评估其可持续性及其对健康结果的影响。

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