{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T03:43:56Z","timestamp":1772163836576,"version":"3.50.1"},"reference-count":27,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["215938\/Z\/19\/Z"],"award-info":[{"award-number":["215938\/Z\/19\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Imperial Patient Safety Translation Research Centre"},{"name":"NHS England and NHS Improvement","award":["P012627"],"award-info":[{"award-number":["P012627"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Emerg Med J"],"accepted":{"date-parts":[[2022,3,30]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To identify the population-level impact of a national pulse oximetry remote monitoring programme for COVID-19 (COVID Oximetry @home (CO@h)) in England on mortality and health service use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using a stepped wedge pre-implementation and post-implementation design, including all 106 Clinical Commissioning Groups (CCGs) in England implementing a local CO@h programme. All symptomatic people with a positive COVID-19 PCR test result from 1 October 2020 to 3 May 2021, and who were aged \u226565 years or identified as clinically extremely vulnerable were included. Care home residents were excluded. A pre-intervention period before implementation of the CO@h programme in each CCG was compared with a post-intervention period after implementation. Five outcome measures within 28 days of a positive COVID-19 test: (i) death from any cause; (ii) any ED attendance; (iii) any emergency hospital admission; (iv) critical care admission and (v) total length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>217\u2009650 people were eligible and included in the analysis. Total enrolment onto the programme was low, with enrolment data received for only 5527 (2.5%) of the eligible population. The period of implementation of the programme was not associated with mortality or length of hospital stay. The period of implementation was associated with increased health service utilisation with a 12% increase in the odds of ED attendance (95%\u2009CI: 6% to 18%) and emergency hospital admission (95%\u2009CI: 5% to 20%) and a 24% increase in the odds of critical care admission in those admitted (95%\u2009CI: 5% to 47%). In a secondary analysis of CO@h sites with at least 10% or 20% of eligible people enrolled, there was no significant association with any outcome measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At a population level, there was no association with mortality before and after the implementation period of the CO@h programme, and small increases in health service utilisation were observed. However, lower than expected enrolment is likely to have diluted the effects of the programme at a population level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/emermed-2022-212378","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T13:21:17Z","timestamp":1649856077000},"page":"575-582","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Population-level impact of a pulse oximetry remote monitoring programme on mortality and healthcare utilisation in the people with COVID-19 in England: a national analysis using a stepped wedge design"],"prefix":"10.1136","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9709-7264","authenticated-orcid":false,"given":"Thomas","family":"Beaney","sequence":"first","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London, UK"},{"name":"Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1495-7746","authenticated-orcid":false,"given":"Jonathan","family":"Clarke","sequence":"additional","affiliation":[{"name":"Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, UK"}]},{"given":"Ahmed","family":"Alboksmaty","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London, UK"},{"name":"Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Kelsey","family":"Flott","sequence":"additional","affiliation":[{"name":"Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Aidan","family":"Fowler","sequence":"additional","affiliation":[{"name":"NHS England and Improvement, London, UK"}]},{"given":"Jonathan","family":"Benger","sequence":"additional","affiliation":[{"name":"NHS Digital, Leeds, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4589-1743","authenticated-orcid":false,"given":"Paul P","family":"Aylin","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Imperial College London, London, UK"},{"name":"Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Sarah","family":"Elkin","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}]},{"given":"Ana Luisa","family":"Neves","sequence":"additional","affiliation":[{"name":"Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[{"name":"Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK"}]}],"member":"239","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"2025090501475612000_39.8.575.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n677"},{"key":"2025090501475612000_39.8.575.2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14052"},{"key":"2025090501475612000_39.8.575.3","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03036-9"},{"key":"2025090501475612000_39.8.575.4","doi-asserted-by":"crossref","first-page":"100799","DOI":"10.1016\/j.eclinm.2021.100799","article-title":"The implementation of remote home monitoring models during the COVID-19 pandemic in England","volume":"34","author":"Vindrola-Padros","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2025090501475612000_39.8.575.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-049235"},{"key":"2025090501475612000_39.8.575.6","unstructured":"NHS England and NHS Improvement . 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