Rapid Response Home Care as an Alternative to Acute Admission

Number of days alive outside of hospital 30 days after initial referral (time of inclusion), including days receiving treatment at home.

Evaluated for both groups. The anatomical focus of infection is categorized as one of the following: eyes, ears, upper respiratory tract, lower respiratory tract, gastrointestinal tract, urinary tract, genital/sexually transmitted disease (STD), bones/joints, skin and soft tissue, unclear focus, or other.

Calculated Early Warning Score (EWS or cEWS) derived from the recorded vital parameters according to a standardized algorithm (i.e. multiple measurements will be aggregated to arrive at one reported value):

Highest measured body temperature (°C, decimal), heart rate (beats per minute), respiratory rate (breaths per minute), peripheral oxygen saturation (SpO₂, %, measured at rest on room air if possible; otherwise oxygen supplementation specified), blood pressure (mmHg, systolic/diastolic, automated or manual), level of consciousness assessed using the AVPU (Alert, verbal, pain, unresponsive) scale

For the intervention group, important events and related timestamps will be collected, indcluding "contact attempted by Central Triage Unit (CTU)" (yes/no)

For the intervention group, important events and related timestamps will be collected, including "home-visit with clinical assesment accepted by the patient" (yes/no; analyzed by intention-to-treat)

For the intervention group, important events and related timestamps will be collected, including response-time by the Rapid response team, calculated as the difference between "time of call" from the CTU to the patient and "time of arrival" of the rapid response team at the patients home (hh:mm)

Video consultation with emergency physician performed during initial assessment? (yes/no).

Physician decision during initial assessment, with the following categorical options: hospital admission; home-based treatment; subacute hospital evaluation; General Practitioner follow-up; or discharge.

First treatment initiated at home, with the following categorical options: IV antibiotics; PO antibiotics; oxygen; IV fluids; inhaled bronchodilators (SABA+SAMA); analgesics; antiemetics; laxatives; glucocorticoids (IV/PO); urinary catheter; airway suctioning; wound care; or other.

Diagnostics performed during the index episode (expected up to three days, but potentially during the entire follow-up period)

• vital signs
• blood tests
• blood gas
• ECG
• other

Clinical course outcomes will be collected for both intervention and control groups:

• hospital admission during the initial episode (yes/no)
• date and time of first admission (related to index episode) (dd-mm-yyyy hh:mm);
• date and time of corresponding discharge

Clinical course outcomes will be collected for both intervention and control groups:

• number of acute readmissions within 30 days,
• time of admission and discharge (dd-mm-yyyy hh:mm)

For each readmission, primary diagnosis will be registered for both intervention and control groups, and it will be assessed whether it was associated with the infection in the index event (yes/no)

Total duration of therapy (integer; continuous days from start date (date of first documented dose), until end date (date of last documented dose) for all episodes with antibiotic treatment from day 0 until day 30)

Type of antibiotic treatment for all episodes with antibiotic treatment from day 0 until day 30), including primary route of administration (intravenous [IV] or oral [PO]), antibiotic agent (name and, if available, dose)

Patient Safety: complications/adverse events during index episode (yes/no, with description; e.g., sepsis, clinical deterioration, new diagnoses)

Patient safety: number of emergency contacts (112/1813) after first contact

For the intervention group, incidents of escalation of care (including transfer to hospital during home-based treatment) will be recorded, including:

Event: yes/no; date and time [dd-mm-yyyy hh:mm]; and reason in free text,

Economic evaluation comparing the intervention and control groups based on the mean total cost per patient (DKK) during the follow-up period. Multiple resource utilization measures will be collected and aggregated to estimate the total cost per patient. These include:

• number of home visits by the mobile team
• time spent per visit (minutes; from departure to completion)
• number of video consultations per patient
• DRG-based costs (DKK) for hospital admissions and outpatient contacts
• team-related costs (DKK; calculated from time × salary and transportation costs)
• laboratory costs (DKK; analyses and materials)
• imaging procedures (type and number)
• specialist consultations (ordered yes/no; number and type).

All resource use will be valued using relevant unit costs and summed to calculate a total cost per patient (DKK). The reported outcome will be the mean total cost per patient in each study group.

recorded as:

• performed (yes/no)
• type of specimen (e.g., blood cultures, urine culture, sputum, throat swab, wound swab)

First available laboratory values obtained at initial clinical assessment. Unit mg/L, integer.

First available laboratory values obtained at initial clinical assessment. Total leukocyte count (×10⁹/L, decimal)

First available laboratory values obtained at initial clinical assessment. Differential counts including lymphocytes, neutrophils, monocytes, eosinophils, and basophils (all ×10⁹/L, decimal)

First available laboratory values obtained at initial clinical assessment. Hemoglobin (mmol/L, decimal)

First available laboratory values obtained at initial clinical assessment. Platelet count (×10⁹/L, integer)

First available laboratory values obtained at initial clinical assessment. Creatinine (µmol/L, integer)

First available laboratory values obtained at initial clinical assessment. Urea (mmol/L, decimal)

First available laboratory values obtained at initial clinical assessment. Sodium [Na⁺] (mmol/L)

First available laboratory values obtained at initial clinical assessment. Potassium [K⁺] (mmol/L)

First available laboratory values obtained at initial clinical assessment. Chloride [Cl-] (mmol/L)

First available laboratory values obtained at initial clinical assessment. Ionized and total calcium [Ca²⁺] (mmol/L)

First available laboratory values obtained at initial clinical assessment. Phosphate (mmol/L)

First available laboratory values obtained at initial clinical assessment. Plasma glucose (mmol/L)

First available laboratory values obtained at initial clinical assessment. Alanine aminotransferase (ALAT, U/L)

First available laboratory values obtained at initial clinical assessment. Albumin (g/L).

pH in arterial or venous blood gas according to local clinical practice.

partial pressure of carbon dioxide (pCO₂) in arterial or venous blood gas according to local clinical practice.

partial pressure of oxygen (pO₂) in arterial or venous blood gas according to local clinical practice.

bicarbonate (HCO₃-) in arterial or venous blood gas according to local clinical practice.

base excess (BE), in arterial or venous blood gas according to local clinical practice.

anion gap (AG) in arterial or venous blood gas according to local clinical practice.

lactate in arterial or venous blood gas according to local clinical practice.