Academic Journal
Hospital bed replacement for acute care of children at home during the COVID-19 pandemic through a Hospital-in-the-Home programme
| العنوان: | Hospital bed replacement for acute care of children at home during the COVID-19 pandemic through a Hospital-in-the-Home programme |
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| المؤلفون: | Bryant, Penelope A, Lawrence, Joanna, Boyce, Suzanne, Simpson, Catherine M, Sinclair, Gemma, Chong, Candie, Lewis, Phillipa, Lee, Stephanie, Hughes, Rebecca, Dalton, Samuel, Lacey, Cara, Nisbet, Lauren C, Smith, Tessa E, Chapman, Sarah, Lakshminarayanan, Swathi, Hurd, Kahlia, Smith, Katie, Savill, Brenda, Ibrahim, Laila F |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2023 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Original research |
| الوصف: | Objectives During the COVID-19 pandemic, we expanded our Hospital-in-the-Home (HITH) programme to increase capacity and manage COVID-19-positive children. We aimed to assess impact on overall HITH activity and COVID-19-positive outcomes. Design Prospective comparative cohort study. Setting The largest paediatric HITH in Australasia, at The Royal Children’s Hospital Melbourne. Patients Children 0–18 years admitted to HITH during the pandemic. Intervention We developed a COVID-19 responsive service, and a guideline for COVID-19-positive patients. We compared overall activity prior to and during the pandemic, and COVID-19-positive admissions with different variants. Main outcomes We compared outcomes for all HITH patients before and during the pandemic, and for COVID-19-positive patients admitted first to hospital versus directly to HITH. Results HITH managed 7319 patients from March 2020 to March 2022, a 21% increase to previously, with a 132% telehealth increase. 421 COVID-19-positive patients (3 days–18.9 years) were admitted to HITH, predominantly high risk (63%) or moderately unwell (33%). Rates of childhood infection in Victoria, with proportion admitted to HITH were: original/alpha variant—3/100 000/month, 0.7%; delta—92/100 000/month, 0.8%; omicron—593/100 000/month, 0.3%. Eligible parents of only 29 of 71 (41%) high-risk children were vaccinated. COVID-19-positive children admitted directly to HITH were less likely to receive COVID-19-specific treatment than those admitted to hospital first (14 of 113 (12%) vs 33 of 46 (72%), p<0.001), reflecting more severe respiratory, but not other features in inpatients. 15 of 159 (10%) were readmitted to hospital, but none deteriorated rapidly. Conclusions COVID-19-positive children at high risk or with moderate symptoms can be managed safely via HITH at home, the ideal place for children during the pandemic. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| Relation: | http://adc.bmj.com/cgi/content/short/108/7/e11; http://dx.doi.org/10.1136/archdischild-2022-325004 |
| DOI: | 10.1136/archdischild-2022-325004 |
| الاتاحة: | http://adc.bmj.com/cgi/content/short/108/7/e11 https://doi.org/10.1136/archdischild-2022-325004 |
| Rights: | Copyright (C) 2023, BMJ Publishing Group Ltd |
| رقم الانضمام: | edsbas.26543B0D |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/archdischild-2022-325004 |
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