TY - JOUR
T1 - Process and implementation evaluation of a virtual hospital model of care for low back pain (Back@Home)
AU - Melman, Alla
AU - Teng, Min Jiat
AU - Coombs, Danielle M.
AU - Li, Qiang
AU - Billot, Laurent
AU - Lung, Thomas
AU - Rogan, Eileen
AU - Marabani, Mona
AU - Hutchings, Owen
AU - Zadro, Joshua R.
AU - Maher, Chris G.
AU - Machado, Gustavo C.
AU - The Back@Home Investigators
AU - Richards, Bethan
AU - Anandacoomarasamy, Ananthila
AU - McCaffery, Kirsten
AU - Shaw, Miranda
AU - Dearing, Cassandra
AU - Harris, Ian
AU - Buchbinder, Rachelle
AU - Needs, Chris
AU - Edwards, James
AU - Ghinea, Narcyz
AU - Dinh, Michael
AU - Chalkley, Dane
AU - Dodd, Rachael
N1 - Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2024/12
Y1 - 2024/12
N2 - Objectives: Low back pain was the sixth most common reason for an ED visit in 2022–2023 in Australia, one-third of these patients were subsequently admitted to hospital. Therefore, we have assessed whether some patients could be diverted to alternate clinical pathways, via admission to a virtual hospital (rpavirtual), and be cared for remotely in their own homes.Methods: Ethics approval was granted for protocols X21-0278 & 2021/ETH10967 and X21-0094 & 2021/ETH00591. We conducted a mixed-method process evaluation, using the RE-AIM framework (reach, effectiveness, adoption, implementation and maintenance) to answer key questions regarding the Back@Home model of care.Results: This preliminary evaluation describes a cohort of the first 50 patients who received care between 13 February and 31 July 2023. The service had high levels of reach and adoption, very low levels of ED representation, and no AEs. Virtual care cost a median of AU$2215 (interquartile range = AU$1724–AU$2855) per admission. Patients admitted virtually had the same high satisfaction with care as traditionally admitted patients and reported less pain and better physical function.Conclusions: Preliminary findings suggest that this model of care is a safe, acceptable, and feasible alternative to hospitalisation for non-serious low back pain, in a select cohort of patients meeting inclusion criteria. Further data collection will inform whether Back@Home has had an impact on length of stay or traditional admission rates.
AB - Objectives: Low back pain was the sixth most common reason for an ED visit in 2022–2023 in Australia, one-third of these patients were subsequently admitted to hospital. Therefore, we have assessed whether some patients could be diverted to alternate clinical pathways, via admission to a virtual hospital (rpavirtual), and be cared for remotely in their own homes.Methods: Ethics approval was granted for protocols X21-0278 & 2021/ETH10967 and X21-0094 & 2021/ETH00591. We conducted a mixed-method process evaluation, using the RE-AIM framework (reach, effectiveness, adoption, implementation and maintenance) to answer key questions regarding the Back@Home model of care.Results: This preliminary evaluation describes a cohort of the first 50 patients who received care between 13 February and 31 July 2023. The service had high levels of reach and adoption, very low levels of ED representation, and no AEs. Virtual care cost a median of AU$2215 (interquartile range = AU$1724–AU$2855) per admission. Patients admitted virtually had the same high satisfaction with care as traditionally admitted patients and reported less pain and better physical function.Conclusions: Preliminary findings suggest that this model of care is a safe, acceptable, and feasible alternative to hospitalisation for non-serious low back pain, in a select cohort of patients meeting inclusion criteria. Further data collection will inform whether Back@Home has had an impact on length of stay or traditional admission rates.
KW - hospital-based home care
KW - low back pain
KW - musculoskeletal pain
KW - telemedicine
UR - http://www.scopus.com/inward/record.url?scp=85203975329&partnerID=8YFLogxK
U2 - 10.1111/1742-6723.14487
DO - 10.1111/1742-6723.14487
M3 - Article
C2 - 39268673
AN - SCOPUS:85203975329
SN - 1742-6731
VL - 36
SP - 929
EP - 937
JO - EMA - Emergency Medicine Australasia
JF - EMA - Emergency Medicine Australasia
IS - 6
ER -