Emily Turner, Emma Johnson, Kate Levin, Stewart Gingles, Elaine Mackay, Claire Roux, Marianne Milligan, Marion Mackie, Kirsten Farrell, Kirsty Murray, Suzanne Adams, Joan Brand, David Anderson, Hannah Bayes
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引用次数: 0
Abstract
The Greater Glasgow & Clyde NHS Trust Community Respiratory Response Team was established to manage patients with chronic respiratory disease at home during the COVID-19 pandemic. The team aimed to avert hospital admission while maximally utilising remote consultations. This observational study analysed outcomes of the triage pathway used, use of remote consultations, hospital admissions and mortality among patients managed by the team. Patients' electronic health records were retrospectively reviewed. Rates of emergency department attendance, hospital admission and death within 28 days of referral were compared across triage pathways. Segmented linear regression was carried out for emergency admissions in Greater Glasgow and Clyde pre- and post- Community Respiratory Response Team implementation, using emergency admissions for chronic obstructive pulmonary disease in the rest of Scotland as control and adjusting for all-cause emergency admissions. The triage category correlated with hospital admission and death. The red pathway had the highest proportion attending the emergency department (21%), significantly higher than the amber and green pathways (p = 0.03 and p = 0.004, respectively). The highest number of deaths were in the blue "end-of-life" pathway (p < 0.001). 87% of interactions were undertaken remotely. Triage severity appropriately led to targeted home visits. No nosocomial COVID-19 infections occurred among patients or staff. The Community Respiratory Response Team was associated with a significant decrease in emergency admissions (RR = 0.96 for each additional month under the Poisson model) compared to the counterfactual if the service had not been in place, suggesting a benefit in reducing secondary care pressures. The Community Respiratory Response Team effectively managed patients with chronic respiratory disease in the community, with an associated reduction in secondary care pressures during the COVID-19 pandemic.
期刊介绍:
npj Primary Care Respiratory Medicine is an open access, online-only, multidisciplinary journal dedicated to publishing high-quality research in all areas of the primary care management of respiratory and respiratory-related allergic diseases. Papers published by the journal represent important advances of significance to specialists within the fields of primary care and respiratory medicine. We are particularly interested in receiving papers in relation to the following aspects of respiratory medicine, respiratory-related allergic diseases and tobacco control:
epidemiology
prevention
clinical care
service delivery and organisation of healthcare (including implementation science)
global health.