The Development and Operation of a Home Management System during the COVID-19 Pandemic: Experience of the Local Government Gyeonggi-do in Korea

Abstract

During the three the coronavirus disease 2019 (COVID-19) surges in South Korea, there was a shortage of hospital beds for COVID-19 patients, and as a result, there were cases of death while waiting for hospitalization. To minimize the risk of death and to allow those confirmed with COVID-19 to safely wait for hospitalization at home, the local government of Gyeonggi-do in South Korea developed a novel home management system (HMS). The HMS team, comprised of doctors and nurses, was organized to operate HMS. HMS provided a two-way channel for the taskforce and patients to monitor the severity of patient's condition and to provide healthcare counseling as needed. In addition, the HMS team cooperated with a triage/bed assignment team to expedite the response in case of an emergency, and managed a database of severity for real-time monitoring of patients. The HMS became operational for the first time in August 2020, initially managing only 181 patients; it currently manages a total of 3,707 patients. The HMS supplemented the government's COVID-19 confirmed case management framework by managing patients waiting at home for hospitalization due to lack of hospital and residential treatment center beds. HMS also could contribute a sense of psychological stability in patients and prevented the situation from worsening by efficient management of hospital beds and reduction of workloads on public healthcare centers. To stabilize and improve the management of COVID-19 confirmed cases, governments should organically develop self-treatment and HMS, and implement a decisive division of roles within the local governments.

Keywords: COVID-19; Gyeonggi-do; Home Management; Infectious Disease Response; Korea; Pandemic Preparedness; Self-isolation; Self-treatment.

Fig. 1. A decision tree of the assignment process for confirmed cases.

(A) The confirmed case is assigned to ‘self-treat’ and stay at home if the patient has little or no symptoms and there is no bed at the RTC. The confirmed patient can receive home management while awaiting hospitalization. (B) The confirmed case is assigned to RTC if the patient has mild symptoms (e.g., cough, sore throat, chill). (C) The confirmed case is assigned to hospitals if the patient has any severe symptoms, loss of consciousness, or any other factors requiring hospitalization (e.g., dyspnea, heart failure, diabetes, dialysis patients, chronic lung disease, chemotherapy, organ transplantation, bedridden). COVID-19 = coronavirus disease 2019, RTC = residential treatment center.