Introduction: Low back pain was the 5th most common reason for an Emergency Department (ED) visit in 2020–21 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 evaluation describes a cohort of the first 50 patients that received care between 13th February – 31st July 2023. The service had high levels of reach and adoption, very low levels of ED representation, and no adverse events. Virtual care cost a median of AU$2215 (IQR 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.
Discussion: Preliminary findings suggest that this model of care is a safe, acceptable, and feasible alternative to hospitalisation for non-serious 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 for non-serious LBP.