Virtual healthcare compared to hospital care for acute and post‐acute illness in adults: A systematic review and meta‐analysis of randomized controlled trials

TL;DR

Virtual healthcare is as safe and effective as hospital care for adults with acute or post-acute illness, with added benefits like higher patient satisfaction and potential cost savings.

Contribution

This study provides the first comprehensive meta-analysis comparing virtual care to inpatient care for acute and post-acute conditions in adults.

Findings

Virtual care showed no significant differences in mortality, readmission, or emergency attendance compared to inpatient care.

Patients reported higher satisfaction with virtual care, and it showed potential for cost savings.

Quality of life outcomes were comparable, with some improvements in pain and emotional well-being in home care settings.

Abstract

To evaluate the clinical effectiveness, cost‐effectiveness, quality of life (QoL) and patient/caregiver satisfaction associated with VWs/HaH vs. traditional inpatient care in adults with acute or post‐acute illness.

We conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), following PRISMA 2020 guidelines, registered with PROSPERO (CRD42024508457). Major databases were searched until October 2024. Primary outcomes were mortality, readmission, emergency attendance and length of stay. Secondary outcomes were quality of life (QoL), cost‐effectiveness, patient satisfaction and caregiver burden. Meta‐analyses employed random‐effects models; heterogeneity was assessed using the I2 statistic.

A total of 47 reports of RCTs (9749 patients) were included. Meta‐analyses showed no statistically significant differences in mortality over 1 to 12‐month periods (OR 0.82‐1.11, 95% CI 0.54‐1.43), readmission rates (OR 0.93‐1.16, 95% CI 0.80‐1.67) or emergency attendance rates (3‐month OR 0.86, 95% CI: 0.6–1.25). Narrative synthesis indicated VWs/HaH had higher patient satisfaction and potential cost savings. Quality of life outcomes were comparable, with some improvements in pain and emotional well‐being noted in home care settings.

VWs/HaH models demonstrated non‐inferior clinical safety and cost‐effectiveness compared to inpatient care for select adult populations. High satisfaction and comparable clinical outcomes were observed. Findings support the continued, regulated integration of virtual care into routine practice. Future research should focus on service standardization, patient/caregiver satisfaction and support and specific economic evaluations.

Figures