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

## TL;DR

A virtual hospital model for low back pain patients did not reduce hospital admissions but cut emergency department returns and improved pain and function.

## Contribution

The study evaluates a virtual hospital model for low back pain patients in emergency departments and its impact on re-presentations and health outcomes.

## Key findings

- The virtual hospital model reduced ED re-presentations within 30 days by 41%.
- Patients reported less pain and better physical function with virtual care.
- Virtual care showed similar or better health outcomes compared to traditional inpatient care.

## 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.