Summary
Effective fast-track ambulatory care pathway for patients with COVID-19 at risk for poor outcome: the COVID-A2R model in a hospital emergency department
Moreno-Pérez O, Ribes I, Fuertes-Kenneally L, Carratalá Perales JM, Román F, Otero-Rodríguez S, González-de la Aleja P, Merino E, Llorens P
Affiliation of the authors
Servicio de Endocrinología y Nutrición, Hospital General Universitario de Alicante, Spain. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain. Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Spain. Servicio de Medicina Interna, Hospital General Universitario de Alicante, Spain. Servicio de Cardiología, Hospital General Universitario de Alicante, Spain. Servicio de Urgencias, Hospital General Universitario de Alicante, Spain. Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
DOI
Quote
Moreno-Pérez O, Ribes I, Fuertes-Kenneally L, Carratalá Perales JM, Román F, Otero-Rodríguez S, et al. Effective fast-track ambulatory care pathway for patients with COVID-19 at risk for poor outcome: the COVID-A2R model in a hospital emergency department. Emergencias. 2022;34:103-10
Summary
Objective.
Methods.
biomarkers of inflammation, and 2) pneumonia with or without elevated inflammatory markers but without respiratory insufficiency. The main outcome was need for an emergency department revisit with hospital admission and time from ED evaluation to hospitalization. Secondary outcomes were the number of COVID-A2R visits and the
potential economic impact.
Results.
diagnosed in 71.8%, and 64.7% required only 1 in-person visit in the COVID-A2R pathway. No revisits to the ED were needed by 87.8% (83.4%–91.1%) of the patients. Of the 34 patients who were hospitalized, 88.2% were admitted
within 5 days. The COVID-A2R model potentially saved 1708 days of hospitalization.
Conclusion. The fast-track ambulatory care model was effective after emergency department discharge of patients with COVID-19 without respiratory insufficiency but with clinical or laboratory indicators of risk for poor outcome.