Virtual Health Care in Hospital-at-Home Models for Patients With Acute Infections: A Scoping Review

Maria Normand Larsen MD , Tatjana Sandreva Dreisig MD , Maja Kjær Rasmussen MSc , Anders N.Ø. Schultz MD , Thyge Lynghøj Nielsen MD, PhD , Thea K. Fischer MD, DMSc
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Abstract

Given the imbalance between high care demand and strained hospital capacity, hospital-at-home (HaH) models offer a potential solution by providing hospital-level care in patients’ homes. This scoping review maps the literature on hospital-led virtual health care within HaH models for acute infections, focusing on intervention characteristics and evaluation designs. Following Johanna Briggs Institute guidelines and PRISMA-ScR, we included studies on virtual and hybrid HaH models using telemedicine for remote monitoring and interventions. The literature searches were performed from October 3, 2022 to October 22, 2022, and updated on July 11, 2024 and identified 15,062 potentially relevant records. From these, 79 studies met the inclusion criteria, highlighting the diversity of HaH models and their evaluations. Hybrid models provided broader treatment options, but many studies lacked detailed intervention descriptions, complicating implementation and meta-analyses. Most studies evaluated patient outcomes, with limited attention to health care staff and relatives. Nearly 45,000 participants were assessed, but only 254 participated in randomized controlled trials, indicating a need for more high-level evidence. Relevant gaps remain, including model heterogeneity and inconsistent reporting.
急性感染患者在医院-家庭模型中的虚拟卫生保健:范围综述
鉴于高护理需求和医院能力紧张之间的不平衡,在家医院(HaH)模式通过在患者家中提供医院级别的护理提供了一个潜在的解决方案。本文综述了医院主导的虚拟卫生保健在急性感染的HaH模型中的文献,重点关注干预特征和评估设计。根据约翰娜布里格斯研究所的指导方针和PRISMA-ScR,我们纳入了使用远程医疗进行远程监测和干预的虚拟和混合HaH模型的研究。文献检索于2022年10月3日至2022年10月22日进行,并于2024年7月11日更新,确定了15062条可能相关的记录。其中,79项研究符合纳入标准,突出了HaH模型及其评估的多样性。混合模型提供了更广泛的治疗选择,但许多研究缺乏详细的干预描述,使实施和荟萃分析复杂化。大多数研究评估的是患者的预后,对医护人员和亲属的关注有限。近4.5万名参与者接受了评估,但只有254人参加了随机对照试验,这表明需要更多的高水平证据。相关差距仍然存在,包括模型异质性和不一致的报告。
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来源期刊
Mayo Clinic Proceedings. Digital health
Mayo Clinic Proceedings. Digital health Medicine and Dentistry (General), Health Informatics, Public Health and Health Policy
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