The following is a summary of “Evaluating the impact of a virtual outpatient care programme in preventing hospitalizations, emergency department visits and mortality for patients with COVID-19: a matched cohort study,” published in the July 2023 issue of the Clinical Microbiology and Infection by Belzile et al.

The objective is to assess the effectiveness of virtual care in preventing superfluous healthcare visits for SARS-CoV-2 patients. Researchers evaluated the COVID-19 Expansion to Outpatients (COVIDEO) program involving virtual assessments for all positive patients in the Sunnybrook assessment center from January 2020 to June 2021, followed by risk-stratified routine follow-up, couriering of oxygen saturation devices and 24-hour/day direct-to-physician pager for urgent questions. 

They linked COVIDEO data to provincial datasets and matched each eligible COVIDEO patient to ≤10 other Ontario SARS-CoV-2 patients based on age, sex, neighborhood, and date. The primary outcome was the emergency department (ED) visit, hospitalization, or mortality within 30 days. Multivariable regression accounted for comorbidities, vaccination, and healthcare utilization before the pandemic. About 73.1% of the 6,508 eligible COVIDEO patients were matched with at least one non-COVIDEO patient. COVIDEO care was protective against the primary composite outcome (adjusted odds ratio [aOR] 0.91, 95% CI, 0.82–1.02), with a reduction in ED visits (7.8% vs 9.6%; aOR 0.79, 95% CI, 0.70–0.89), but increase in hospitalizations (3.8% vs 2.7%, aOR 1.37, 95% CI, 1.14–1.63) reflecting more direct-to-ward admissions (1.3% vs 0.2%, P < 0.0001). 

Results were comparable when matched comparators were restricted to patients who had not received virtual care elsewhere, with a decrease in ED visits (7.8 vs 8.6%, aOR 0.86, 95% CI, 0.75–0.99) and an increase in hospitalizations (3.7 vs 2.4%, aOR 1.45, 95% CI, 1.17–1.80). A comprehensive remote care program can prevent unnecessary ED visits and facilitate direct-to-ward hospitalizations, mitigating the effects of COVID-19 on the healthcare system.

Source: sciencedirect.com/science/article/pii/S1198743X23001544