Cost Evaluation of COVID-19 Remote Home Monitoring Services' Patients in England during Wave 2 from October 2020-April 2021

OBJECTIVES: During the COVID-19 pandemic, the NHS delivered a community-based remote home monitoring service for COVID-19 patients. The service came in two models characterised based on the referral method: home-based care to ensure the right people were admitted at hospital at the right time (named COVID Oximetry @ home (CO@h)) and facilitation of patients’ transition when discharged home (named Covid-19 Virtual Ward (CVW)). Patients were provided with pulse oximeters and asked to regularly record and submit oxygen levels and other symptoms to a team of administrators and clinicians via digital means (tech-enable and analogue mode) and/or over the phone (analogue). Our aim was to evaluate the costs of implementing these services in England during wave 2 of the pandemic (October 2020-April 2021).

METHODS: We used a top-down approach to describe the costs of setting-up and running the service. 26 sites reported the number of patients and staff members involved in the service, and other used resources. Descriptive statistics and multivariate regression analysis were used appropriately.

RESULTS: The mean cost per patient monitored was lower in the CO@h service compared to the CVW (£527.5 vs. £599.1). The corresponding cost was lower for sites using tech-enabled and analogue data submission mode compared to sites using analogue-only mode for both CO@h (£515 vs. £561) and CVW (£584 vs. £612) services. The number of patients enrolled in the service and the service type significantly affected the mean cost per patient (b=0.62, p= 0.001; b=-457.99, p=0.05 correspondingly).

CONCLUSIONS: Our analysis offers a model for future research since it covers sites of various sizes and raises questions about different practices within the overall remote monitoring services.