Effectiveness of a virtual hospital model of care for patients with low back pain presenting to emergency departments (Back@Home)

This study evaluated the effectiveness of a virtual hospital model of care (Back@Home) for low back pain (LBP). We conducted an observational study across four hospitals in the Sydney Local Health District, Australia. We included patients aged ≥16 years presenting to the ED with a primary diagnosis of non-specific or radicular (non-serious) LBP. We performed logistic or linear mixed models and multivariate linear regression analyses. From January 2017 to January 2025, 18,851 patients presented to the ED with non-serious LBP. The Back@Home model of care did not significantly affect admissions to inpatient or short-stay units (OR: 1.19, 95% CI: 0.46 to 3.06). However, it reduced ED re-presentations within 30 days (OR: 0.59, 95% CI: 0.42 to 0.84) by 41%. Patients who received virtual hospital care reported less pain (β: -1.26, 95% CI: -2.22 to -0.30), better physical function (β: 4.81, 95% CI: 2.36 to 7.27) and similar satisfaction (β: 0.14; 95% CI: -0.72 to 1.01) with care compared to those receiving inpatient care. Back@Home did not reduce admissions for LBP, but the model of care resulted in fewer ED re-presentations. Although causal inference cannot be made, virtual care may deliver health outcomes comparable to, or better than, traditional care.

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Publication Details

Journal
npj Digital Medicine
Published
2026-02-27
DOI
https://doi.org/10.1038/s41746-026-02425-8
Primary Topic
Telemedicine and Telehealth Implementation
Type
article
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article

Effectiveness of a virtual hospital model of care for patients with low back pain presenting to emergency departments (Back@Home)

Crystian B. Oliveira, Mona Marabani, Danielle Coombs, Q. Li et al.
npj Digital Medicine
Telemedicine and Telehealth Implementation
article

Effectiveness of a virtual hospital model of care for patients with low back pain presenting to emergency departments (Back@Home)

Crystian B. Oliveira, Mona Marabani, Danielle Coombs, Q. Li, Owen Hutchings, Rachael H Dodd, Gustavo Machado, Rachelle Buchbinder, Alla Melman, Chris Needs, Ananthila Anandacoomarasamy, Narcyz Ghinea, Miranda Shaw, Bethan Richards, Min Jiat Teng, Dane R Chalkley, Chris G. Maher, Joanne Edwards, Back Home Investigators, Chris Gianacas, Chathurani Sigera, Ian Harris, Kirsten McCaffery, Laurent Billot, Michael Dinh, Eileen Rogan
article en

Abstract

This study evaluated the effectiveness of a virtual hospital model of care (Back@Home) for low back pain (LBP). We conducted an observational study across four hospitals in the Sydney Local Health District, Australia. We included patients aged ≥16 years presenting to the ED with a primary diagnosis of non-specific or radicular (non-serious) LBP. We performed logistic or linear mixed models and multivariate linear regression analyses. From January 2017 to January 2025, 18,851 patients presented to the ED with non-serious LBP. The Back@Home model of care did not significantly affect admissions to inpatient or short-stay units (OR: 1.19, 95% CI: 0.46 to 3.06). However, it reduced ED re-presentations within 30 days (OR: 0.59, 95% CI: 0.42 to 0.84) by 41%. Patients who received virtual hospital care reported less pain (β: -1.26, 95% CI: -2.22 to -0.30), better physical function (β: 4.81, 95% CI: 2.36 to 7.27) and similar satisfaction (β: 0.14; 95% CI: -0.72 to 1.01) with care compared to those receiving inpatient care. Back@Home did not reduce admissions for LBP, but the model of care resulted in fewer ED re-presentations. Although causal inference cannot be made, virtual care may deliver health outcomes comparable to, or better than, traditional care.

npj Digital MedicineVol. 9(1)
The University of Sydney (AU), Royal Prince Alfred Hospital (AU), Sydney Hospital (AU), UNSW Sydney (AU), The George Institute for Global Health (AU), Institute for Musculoskeletal Health (AU), Sydney Local Health District (AU), Ingham Institute (AU), Cancer Council NSW (AU)
Good health and well-being
Openalex Percentile: Top 44%
Telemedicine and Telehealth Implementation
DOIOpen Access PDFOpenAlex
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