{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:28:00Z","timestamp":1772177280042,"version":"3.50.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008132","name":"HCF Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008132","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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 \u226516 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 (\u03b2: -1.26, 95% CI: -2.22 to -0.30), better physical function (\u03b2: 4.81, 95% CI: 2.36 to 7.27) and similar satisfaction (\u03b2: 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.<\/jats:p>","DOI":"10.1038\/s41746-026-02425-8","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:17:09Z","timestamp":1772169429000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a virtual hospital model of care for patients with low back pain presenting to emergency departments (Back@Home)"],"prefix":"10.1038","volume":"9","author":[{"given":"Chathurani","family":"Sigera","sequence":"first","affiliation":[]},{"given":"Crystian B.","family":"Oliveira","sequence":"additional","affiliation":[]},{"given":"Alla","family":"Melman","sequence":"additional","affiliation":[]},{"given":"Min Jiat","family":"Teng","sequence":"additional","affiliation":[]},{"given":"Danielle M.","family":"Coombs","sequence":"additional","affiliation":[]},{"given":"Laurent","family":"Billot","sequence":"additional","affiliation":[]},{"given":"Chris","family":"Gianacas","sequence":"additional","affiliation":[]},{"given":"Alamgir","family":"Kabir","sequence":"additional","affiliation":[]},{"given":"Eileen","family":"Rogan","sequence":"additional","affiliation":[]},{"given":"Mona","family":"Marabani","sequence":"additional","affiliation":[]},{"given":"Owen","family":"Hutchings","sequence":"additional","affiliation":[]},{"given":"Chris G.","family":"Maher","sequence":"additional","affiliation":[]},{"given":"Gustavo C.","family":"Machado","sequence":"additional","affiliation":[]},{"name":"Back@Home Investigators","sequence":"additional","affiliation":[]},{"given":"Ananthila","family":"Anandacoomarasamy","sequence":"additional","affiliation":[]},{"given":"Bethan","family":"Richards","sequence":"additional","affiliation":[]},{"given":"Chris","family":"Needs","sequence":"additional","affiliation":[]},{"given":"Dane","family":"Chalkley","sequence":"additional","affiliation":[]},{"given":"Ian","family":"Harris","sequence":"additional","affiliation":[]},{"given":"James","family":"Edwards","sequence":"additional","affiliation":[]},{"given":"Kirsten","family":"McCaffery","sequence":"additional","affiliation":[]},{"given":"Michael","family":"Dinh","sequence":"additional","affiliation":[]},{"given":"Miranda","family":"Shaw","sequence":"additional","affiliation":[]},{"given":"Narcyz","family":"Ghinea","sequence":"additional","affiliation":[]},{"given":"Qiang","family":"Li","sequence":"additional","affiliation":[]},{"given":"Rachael","family":"Dodd","sequence":"additional","affiliation":[]},{"given":"Rachelle","family":"Buchbinder","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2425_CR1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.semarthrit.2016.07.013","volume":"46","author":"E Yelin","year":"2016","unstructured":"Yelin, E., Weinstein, S. & King, T. The burden of musculoskeletal diseases in the United States. Semin. Arthritis Rheumat. 46, 259\u2013260, https:\/\/doi.org\/10.1016\/j.semarthrit.2016.07.013 (2016).","journal-title":"Semin. Arthritis Rheumat."},{"key":"2425_CR2","unstructured":"National Health Service England. Hospital Admitted Patient Care Activity, 2023\u20132024, https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/hospital-admitted-patient-care-activity\/2023-24 (2024)."},{"key":"2425_CR3","unstructured":"Australian Institute of Health and Welfare. Back problems. https:\/\/www.aihw.gov.au\/reports\/chronic-musculoskeletal-conditions\/back-problems (2023)."},{"key":"2425_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2020.100089","volume":"7","author":"DM Coombs","year":"2021","unstructured":"Coombs, D. M. et al. Healthcare costs due to low back pain in the emergency department and inpatient setting in Sydney, Australia. Lancet Reg. Health West Pac. 7, 100089. https:\/\/doi.org\/10.1016\/j.lanwpc.2020.100089 (2021).","journal-title":"Lancet Reg. Health West Pac."},{"key":"2425_CR5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.ajem.2024.07.035","volume":"84","author":"X Xu","year":"2024","unstructured":"Xu, X., Chen, Q., Oliveira, C. B., Maher, C. G. & Machado, G. C. Emergency department length of stay and re-presentation rates in patients with low back pain: a medical record review study. Am. J. Emerg. Med. 84, 33\u201338, https:\/\/doi.org\/10.1016\/j.ajem.2024.07.035 (2024).","journal-title":"Am. J. Emerg. Med."},{"key":"2425_CR6","doi-asserted-by":"publisher","first-page":"e21906","DOI":"10.7759\/cureus.21906","volume":"14","author":"M Megalla","year":"2022","unstructured":"Megalla, M. et al. Factors associated with repeat emergency department visits for low back pain. Cureus 14, e21906, https:\/\/doi.org\/10.7759\/cureus.21906 (2022).","journal-title":"Cureus"},{"key":"2425_CR7","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1007\/s10067-022-06054-w","volume":"41","author":"A Melman","year":"2022","unstructured":"Melman, A., Maher, C. G., Needs, C. & Machado, G. C. Many people admitted to hospital with a provisional diagnosis of nonserious back pain are subsequently found to have serious pathology as the underlying cause. Clin. Rheumatol. 41, 1867\u20131871, https:\/\/doi.org\/10.1007\/s10067-022-06054-w (2022).","journal-title":"Clin. Rheumatol."},{"key":"2425_CR8","doi-asserted-by":"publisher","first-page":"e043285","DOI":"10.1136\/bmjopen-2020-043285","volume":"11","author":"MQ Leong","year":"2021","unstructured":"Leong, M. Q., Lim, C. W. & Lai, Y. F. Comparison of Hospital-at-Home models: a systematic review of reviews. 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