Aim
To compare health services and patient-reported outcomes of people presenting to ED with LBP before and after the implementation of a virtual hospital model of care for LBP (Back@Home).
Study design
A hybrid effectiveness-implementation type-I study
Methods
Patients presenting to the ED were included if they were aged 16 years or older and had a primary diagnosis of musculoskeletal LBP. The implementation strategy included educational meetings, local opinion leaders, and local consensus discussions. Outcomes will be compared before and after the implementation of the virtual hospital model of care. Surveys collected pain intensity, physical function and satisfaction with care at 2 weeks after admission. The health service outcomes included mean length of hospital stay, the proportion of ED presentations that result in a traditional hospital, the monthly proportion of admitted patients represented to traditional hospital, including representations to the ED within 48 hours since discharge and readmissions to an inpatient unit within 28 days. Descriptive statistics were conducted to report the results of the patient-reported outcomes and regression analyses will be performed to obtain the between group differences.
Results
From December 2021 to July 2024, a total of 107 inpatients were monitored and 198 patients were cared for through Back@Home. Fifty-three patients admitted to the traditional hospital and 102 patients admitted to the virtual hospital completed the 2-week follow-up assessment. The mean (SD) pain intensity, physical function and satisfaction of patients admitted to traditional and virtual hospitals were, respectively: 5.6 (2.6) vs 4.2 (2.5); 14.6 (8.9) vs 20.5 (6.6); and 7.6 (2.6) vs 7.8 (2.3).
Conclusion
The virtual hospital has shown promising evidence that it provides equivalent or better outcomes compared to the traditional hospital for LBP. The final results, including the between-group differences of the service and patient-reported outcomes, will be presented at the conference.