• Yasushi Tsujimoto, Masanori Kobayashi, Tomohisa Oku, Takahisa Ogawa, Shinichi Yamadera, Masako Tsukamoto, Noriya Matsuda, Morikazu Nishihira, Yu Terauchi, Takahiro Tanaka, Yoshitaka Kawabata, Yuki Miyamoto, Yoshiki Morikami, and KISA2-Tai Osaka.
• Oku Medical Clinic, Shimmori 7-1-4, Asahi-ku, Osaka, Japan.
• Fam Pract. 2023 Dec 22; 40 (5-6): 662670662-670.

BackgroundHospital-at-home (HaH) care has been proposed as an alternative to inpatient care for patients with coronavirus disease (COVID-19). Previous reports were hospital-led and involved patients triaged at the hospitals. To reduce the burden on hospitals, we constructed a novel HaH care model organized by a team of local primary care clinics.MethodsWe conducted a multicentre retrospective cohort study of the COVID-19 patients who received our HaH care from 1 January to 31 March 2022. Patients who were not able to be triaged for the need for hospitalization by the Health Center solely responsible for the management of COVID-19 patients in Osaka city were included. The primary outcome was receiving medical care beyond the HaH care defined as a composite outcome of any medical consultation, hospitalization, or death within 30 days from the initial treatment.ResultsOf 382 eligible patients, 34 (9%) were triaged for hospitalization immediately after the initial visit. Of the remaining 348 patients followed up, 37 (11%) developed the primary outcome, while none died. Obesity, fever, and gastrointestinal symptoms at baseline were independently associated with an increased risk of needing medical care beyond the HaH care. A further 129 (37%) patients were managed online alone without home visit, and 170 (50%) required only 1 home visit in addition to online treatment.ConclusionsThe HaH care model with a team of primary care clinics was able to triage patients with COVID-19 who needed immediate hospitalization without involving hospitals, and treated most of the remaining patients at home.© The Author(s) 2023. Published by Oxford University Press.

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