Is it Virtually Worth It? Cost Analysis of Telehealth Monitoring for Community-based COVID-19-positive Patients
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background: A major cost to healthcare delivery in Ontario is hospital visits. Innovations averting unnecessary hospitalizations and emergency department (ED) visits are, therefore, of paramount importance for system sustainability. A multidisciplinary clinic called the London Health Sciences Center Urgent COVID Care Clinic (LUC3) pioneered acute care for community-based COVID19-positive patients via telephone assessments paired with in-home pulse oximetry. Objectives: To identify and analyze costs and savings associated with LUC3. Methods: A retrospective observational analysis of all COVID19-positive patients referred to LUC3 between April 23, 2020 and Aug 31, 2020. We compared the cost of operating LUC3 with savings accrued from diverted or averted ambulatory visits and inpatient admissions. Two independent non-LUC3 physicians adjudicated diverted or averted hospital visits. Results: A total of 117 patients were followed for 60 days. LUC3 saved $25,495 by preventing 25 unnecessary ED visits and replacing 228 in-person appointments with telephone assessments. The net savings after accounting for LUC3 operational costs, intentional ED visits, and admissions was $11,759. Conclusions & Implications: Telemedicine clinics can be cost-beneficial when treating community-based patients with acute illnesses, provided there is ready access to physicians and use of appropriate in-home monitoring. These lessons should be applied to other acute patient populations as Canada’s healthcare system seeks resource reallocation opportunities.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it