• Am J Manag Care · Jun 2022

    An accelerated hospital observation pathway to reduce length of stay for patients with COVID-19.

    • Austin S Kilaru, Stefanie B Porges, Lindsay Grossman, M Kit Delgado, Anna U Morgan, Krisda H Chaiyachati, David A Asch, S Ryan Greysen, Amy C Lockwood, Keith C Hemmert, Susan McGinley, Nancy Mannion, Ann Marie Huffenberger, Eric Bressman, Nina O'Connor, Neda Khan, Mohan Balachandran, Christopher K Snider, Aria Xiong, Nandita Mitra, and Kathleen C Lee.
    • University of Pennsylvania, 1310 Blockley Hall, 421 Guardian Dr, Philadelphia, PA 19104. Email: austin.kilaru@pennmedicine.upenn.edu.
    • Am J Manag Care. 2022 Jun 1; 28 (6): 262-268.

    ObjectivesStrategies to maintain hospital capacity during the COVID-19 pandemic included reducing hospital length of stay (LOS) for infected patients. We sought to evaluate the association between LOS and enrollment in the COVID Accelerated Care Pathway, which consisted of a hospital observation protocol and postdischarge automated text message-based monitoring.Study DesignRetrospective matched cohort study of patients hospitalized from December 14, 2020, to January 31, 2021.MethodsParticipants were patients who presented to the emergency department with acute infection due to COVID-19, required hospitalization, and met pathway inclusion criteria. Participants were compared with a propensity score-matched cohort of patients with COVID-19 admitted to the same hospital during the 7 weeks preceding and following pathway implementation.ResultsThere were 44 patients in the intervention group and 83 patients in the propensity score-matched cohort. The mean (SD) hospital LOS for patients in the intervention group was 1.7 (2.6) days compared with 3.9 (2.3) days for patients in the matched cohort (difference, -2.2 days; 95% CI, -3.3 to -1.1). In the intervention group, 2 patients (5%; 95% CI, 0%-15%) were rehospitalized within 14 days compared with 8 (10%; 95% CI, 4%-17%) in the matched cohort.ConclusionsPatients with COVID-19 who were managed through an accelerated hospital observation protocol and postdischarge monitoring service had reduced hospital LOS compared with patients receiving standard care. Hospital preparedness for future public health emergencies may involve the design of pathways that reduce the time that patients spend in the hospital, lower cost, and ensure continued recovery upon discharge.

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