Compared with current standard care for COVID-19 patients with moderate to severe illness in the USA, remote pulse-oximetry monitoring is associated with lower costs and improved outcomes by increasing "the specificity of those requiring follow-up care for escalating symptoms", say researchers who published their findings in Value in Health.

They developed a Markov model with a 3-week time horizon from a US health-sector perspective to compare remote pulse-ox monitoring versus standard care in patients presenting with moderate to severe COVID-19 symptoms. For remote monitoring, patients remained at home with a pulse-ox transmitting vital signs to a hospital for 5 days; for standard care (hospitalisation), patients were assumed to be under observation at the hospital for 7 days. Costs (2020 values) and outcomes were derived from real-world data from a university hospital and published literature. The cost-effectiveness threshold was $US100 000 per quality-adjusted life year (QALY).

Remote pulse-ox monitoring dominated current standard care: remote monitoring reduced costs by $11 472 and resulted in 0.013 more QALYs gained, yielding an incremental net monetary benefit of $12 809 per QALY. There were also 87% fewer hospitalisations and 77% fewer deaths in patients receiving remote pulse-ox monitoring. Sensitivity analyses confirmed the robustness of the results.

"At-home telemonitoring with pulse-ox devices presents a cost-effective solution to handle surges of patients presenting with COVID-19 symptoms in the ED [emergency department]", conclude the authors.