Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 1, 2022
Date Accepted: Mar 20, 2023
Date Submitted to PubMed: May 3, 2023
Home monitoring of patients with mild Covid-19: effectiveness and medico-economic evaluation of the Covidom cohort at 18 months
ABSTRACT
Background:
Covidom was a telesurveillance solution for home monitoring of patients with mild to moderate Covid-19, deployed in March 2020 in the greater Paris area to alleviate the burden on the healthcare system. The Covidom solution included a free web application with daily monitoring questionnaires and a regional control center to quickly handle patient alerts, including dispatching emergency medical services if necessary.
Objective:
We aim to provide an overall evaluation of the Covidom solution 18 months after its inception.
Methods:
Our primary outcome is the number of handled alerts and response escalation. Then, we analyzed Covidom safety including its ability to detect clinical worsening defined as hospitalization or death and the number of worsening without any preceding alert. We evaluated the cost of Covidom, and compared the cost of Covid-19 hospitalizations between Covidom and non-Covidom patients among mild Covid-19 cases presenting at Emergency Departments of the largest network of hospitals in the greater Paris area. Finally, we reported on user satisfaction.
Results:
From 60,073 patients monitored by Covidom, the regional control center handled 285,496 alerts, dispatching emergency medical services 518 times. Of the 947 patients experiencing clinical worsening while adhering to the daily monitoring, only 35 (1.4%; 35 were hospitalized and one died) did not previously trigger alerts. The cost of Covidom was 54€ per patient, and the cost of hospitalization for Covid-19 worsening seemed lower than in the general population. Patients that responded to the satisfaction questionnaire rated Covidom highly, rating the likelihood to recommend Covidom with a median of 9 out of 10.
Conclusions:
Covidom may have contributed to alleviate the pressure on healthcare system in the initial months of the pandemic, though its impact may be lower than anticipated. Covidom seems safe for home monitoring of patients with a mild to moderate Covid-19.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.