Home Care as a safe alternative during the COVID-19 crisis

Abstract

SUMMARY INTRODUCTION: There are several reports worldwide about the high mortality related to COVID-19 among residents of nursing homes. The worldwide concern about the safety of patients and professionals in these institutions is relevant. In Brasil, a large part of post-acute care and chronic patients is performed at home through Home Care (HC). OBJECTIVE: This study aims to evaluate the incidence of COVID-19 in Home Care patients and the clinical outcomes of these patients; it also aims to assess the impact of the epidemic on the number of patients, new admissions, and hospitalizations. METHODS: A descriptive study of the COVID-19 cases that affected the population in care by Home Doctor (a private company of Home Care), between the months of March 2020 and May 2020 and analysis of the total number of patients, the hospitalization and death rate in the period compared to the pre-epidemic period. RESULTS: There were 31 confirmed cases of COVID-19, 21 of which were male, mean age 73 years. All patients had multiple comorbidities, the most prevalent were: Systemic Arterial Hypertension (54%) and Stroke (35%). The incidence of COVID-19 was 1% in the studied population. There were 10 hospitalizations with 5 hospital deaths and one case of home death (lethality 19%). Safe care was maintained, with a low death rate (0.6%) and hospitalization (6.1%). CONCLUSION: Home Care is able to maintain safe care during the pandemic due to COVID-19, with a low incidence of COVID-19, low hospitalization rate, and low mortality when compared to nursing homes institutions.

The impact of the SARS‐CoV‐2 pandemic on the management of chronic limb‐threatening ischemia and wound care

“…There is conflicting evidence, mostly Level 4 and some Level 5, that the rate of home healthcare visits is much lower during the pandemic. This finding is regionally dependent; countries, such as Brazil, with established home care systems integrated into their health systems have seen a surge in visits 83 . In wound care, patients are encouraged to receive care at home as much as possible 21…”

“…The use of telemedicine and home care together has exploded during the pandemic, indicating that the traditional home healthcare model is transforming to a hybrid model of in‐person care at home with remote monitoring and management (Figure 1). 21,71,72,80,83,90 A private home care agency in Brazil, where wound care is often performed at home, reported a 15% increase of 305 patients/month between January and May 2020 83 . There were 2931 patients (mean age: 73 years) treated in home care during the 1st quarter of the pandemic, with virtual consultations making up 54% of doctor visits and 44% of nurse visits.…”

COVID-19 challenges and changes for home care agencies and providers: a scoping review protocol

“…In the US, when the Centers for Disease Control and Prevention (CDC) and national health leaders encouraged, and in some cases, ordered Americans to stay home, home health care became not merely an idea but a necessary reality for many 14 . This reality was not only recognized in America but around the globe 3,5,14,15 . Additionally, since the goal of home care is to aid in preventing hospital admission and help patients remain in their homes, it was also used as a way to prevent the at-risk older population from unnecessary exposure to COVID-19 in health care facilities.…”

A solo career in Brunei Darussalam

“…The perspective of a project on technology and healthcare system collaborating multiple disciplines are needed at times (Landers et al, 2016). Designing home care providers for caregivers in the home environment would be a promising strategy to optimize the health system (Gaspar et al, 2020). Brunei Darussalam is a small country having so much attention to the development of home care services (Al Munawar, Wint, Low, & Anshari, 2012).…”