COVID-19 community care in Israel-a nationwide cohort study from a large health maintenance organization

Shirley Shapiro Ben David*, Daniella Cohen, Rebekah Karplus, Angela Irony, Gili Ofer-Bialer, Israel Potasman, Orly Greenfeld, Joseph Azuri, Nachman Ash

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Among the many medical challenges presented by the COVID-19 pandemic, management of the majority of patients in community outpatient settings is crucial. The aim of this study was to describe the characteristics and outcomes among confirmed COVID-19 cases who were managed at three settings: two outpatient settings and one inpatient. Methods: A retrospective database cohort study was conducted in a large Israeli Health Maintenance Organization. All COVID-19 cases diagnosed between 28 February 2020 and 20 July 2020 were included. Cases in the community settings were managed through a nationwide remote monitoring center, using preliminary telehealth triage and 24/7 virtual care. Outcome parameters included hospital admission, disease severity, need for respiratory support and mortality. Results: About 5448 cases, aged range 0-97 years, were enrolled; 88.7% were initially managed as outpatient either at home or in designated hotels, 3.1 and 2.1% of them, respectively, later required hospitalization. The main reason for hospitalization was dyspnea; 12 were diagnosed with severe disease; 56 patients (1.3%) died, five (0.1%) of whom were initially allocated to the outpatient settings. Conclusions: Care for appropriately selected COVID-19 patients in the community provides a safe and effective option. This can contribute to reducing the hospitalization burden, with no evidence of increased morbidity or mortality.

Original languageEnglish
Pages (from-to)723-730
Number of pages8
JournalJournal of Public Health
Issue number4
StatePublished - 1 Dec 2021


  • COVID-19
  • Community
  • Healthcare system
  • Outpatient management
  • Telehealth


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