{
  "abstract": "Objectives In 2020–21, more than 145,000 patients with low back pain (LBP) presented to emergency departments (ED) and one-third of these patients were subsequently admitted to hospital. Although virtual hospitals may be effective in avoiding hospital admissions, their effects on the health outcomes of patients with LBP are still unclear. This study aims to compare health service 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).Method This is a hybrid effectiveness-implementation type-I study, runs across three hospitals in the Sydney Local Health District. Data were collected through quantitative healthcare utilisation data and qualitative interviews with patients and clinicians. 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. Patient-reported outcomes were collected at 2 weeks after admission to (i) the traditional hospital wards and (ii) the new virtual hospital for LBP. Surveys collected pain intensity, physical function and satisfaction with care. Descriptive statistics were conducted to report the results for this preliminary analysis using the patient-reported outcomes at 2-week follow-up. Outcomes will be compared before and after the implementation of the virtual hospital model of care using logistic mixed model with random intercepts.Results From December 2021 to July 2024, a total of 107 inpatients were monitored, and 205 patients received care through Back@Home. During their Back@Home admission, 86% of patients had at least one consultation with a physician, and 92% received virtual physiotherapy care. Approximately 93% of patients received heat wraps delivered to their homes, and 21% were assigned an exercise program via the PhysiTrack app. The mean (SD) pain intensity, physical function and satisfaction of patients admitted to traditional and virtual hospitals were, respectively: 5.6 (2.6) vs 4.1 (2.6) out of 10; 14.6 (8.9) vs 20.5 (11.3) out of 30; and 7.6 (2.6) vs 7.8 (2.3) out of 10. Patients and virtual clinicians reported positive experiences with the Back@Home program, highlighting personalised support. Also, there were very low level of representations (3.9%), and no adverse events reported. The final results including group differences of the services will be presented at the conference.Conclusions The virtual hospital has shown promising evidence it provides equivalent or better outcomes compared to the traditional hospital for LBP.",
  "authors": [
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
      ],
      "name": "Ponsuge Chathurani Sigera"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
      ],
      "name": "Alla Melman"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
      ],
      "name": "Crystian Oliveira"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "RPA Virtual Hospital, Sydney Local Health District, Sydney, Australia"
      ],
      "name": "Min Jiat Teng"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
      ],
      "name": "Danielle M Coombs"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
      ],
      "name": "Chris G Maher"
    },
    {
      "affiliations": [
        "Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia",
        "School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
      ],
      "name": "Gustavo C Machado"
    }
  ],
  "title": "109 Implementation of a virtual hospital model of care for low back pain (back@home)",
  "uid": "47c06289-b395-5c69-a7ac-7842bbf15d79"
}