Evidence map›Paper›PMID 39589741›Full record

ArticleJAMA network open2024

Virtual Home Care for Patients With Acute Illness.

Josh Banerjee, Christopher Lynch, Hugh Gordon, Charles E Coffey, Catherine P Canamar, Soodtida Tangpraphaphorn, Karla Gonzalez, Neha Mahajan, Jan Shoenberger, Michael Menchine and 63 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Virtual Wards for Acute Care Patients: A Scoping Review.Journal of general internal medicine · 2026
    Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Lessons from a large national "hospital at home" program.Israel journal of health policy research · 2025
    Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

73 authors.

Josh BanerjeeHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Christopher LynchHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Hugh GordonHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Charles E CoffeyHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Catherine P CanamarQuality, Los Angeles General Medical Center, Los Angeles, California.
Soodtida TangpraphaphornQuality, Los Angeles General Medical Center, Los Angeles, California.
Karla GonzalezUrgent Care, Los Angeles General Medical Center, Los Angeles, California.
Neha MahajanUrgent Care, Los Angeles General Medical Center, Los Angeles, California.
Jan ShoenbergerEmergency Medicine, Los Angeles General Medical Center, Los Angeles, California.
Michael MenchineEmergency Medicine, Los Angeles General Medical Center, Los Angeles, California.
Andrew OhEmergency Medicine, Los Angeles General Medical Center, Los Angeles, California.
Emily JohnsonEmergency Medicine, Los Angeles General Medical Center, Los Angeles, California.
Molly GrassiniEmergency Medicine, Los Angeles General Medical Center, Los Angeles, California.
Rachel BadenMedicine, Los Angeles General Medical Center, Los Angeles, California.
Paul HoltomInfectious Diseases, Los Angeles General Medical Center, Los Angeles, California.
Douglass HutcheonHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Brandon M WileyCardiology, Los Angeles General Medical Center, Los Angeles, California.
Kusha DavarInfectious Diseases, Los Angeles General Medical Center, Los Angeles, California.
Sheila Mallet-SmithDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Margaret SanfratelloDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Brenda GallardoDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Meixine SongDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Nikole SwainDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Maria Lydia SolisDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Jenny SilvaDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Charmaine PablicoDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Eduardo AcevesDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Erica BonillaDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Ria Ashley LegaspiDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Deisy M GuevaraDepartment of Nursing, Los Angeles General Medical Center, Los Angeles, California.
Karissa LeeCardiology, Los Angeles General Medical Center, Los Angeles, California.
Christina MartinezCardiology, Los Angeles General Medical Center, Los Angeles, California.
Michelle BanhHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Dana RussellHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Lissette CervantesHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Jacqueline CervantesHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Cesar GonzalezHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Phillip ShethHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Shadi DowlatshahiHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Alex RosenbergHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Pruthul PatelHospital Medicine, Los Angeles General Medical Center, Los Angeles, California.
Wei-An LeeHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Tanzim KhanLimb Salvage Program, Rancho Los Amigos Medical Center, Downey, California.
Tze-Woei TanLimb Salvage Program, Rancho Los Amigos Medical Center, Downey, California.
Michael FongDivision of Cardiovascular Medicine, Keck School of Medicine of USC, Los Angeles, California.
Samuel S GordonCardiology, Los Angeles General Medical Center, Los Angeles, California.
Brandi ClarkHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Victor PenaHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Steven DohiDepartment of Pharmacy, Los Angeles General Medical Center, Los Angeles, California.
Beatrisa BannisterDepartment of Pharmacy, Los Angeles General Medical Center, Los Angeles, California.
Roman VillaltaInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Priya InduruInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Pauline VuongInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
David LweInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Karen StoffelInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Sam OhInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Christian VoyageurInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Andrew CoolInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Yong LeeInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Stephen LenhInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Janet LuongInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Gary HannaInformation Systems, Los Angeles General Medical Center, Los Angeles, California.
Jason N DoctorUSC Price School of Public Policy, Los Angeles, California.
Bryan MunozUSC Price School of Public Policy, Los Angeles, California.
Concepcion CastroPublic Information, Los Angeles General Medical Center, Los Angeles, California.
Edgar SolisHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Nancy BlakeHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Roza SakzalyanLos Angeles County Department of Health Services, Los Angeles, California.
Christopher J RodriguezLos Angeles County Department of Health Services, Los Angeles, California.
Christina GhalyLos Angeles County Department of Health Services, Los Angeles, California.
Jorge OrozcoHospital Administration, Los Angeles General Medical Center, Los Angeles, California.
Hal F YeeLos Angeles County Department of Health Services, Los Angeles, California.
Brad SpellbergHospital Administration, Los Angeles General Medical Center, Los Angeles, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Recent evolutions in clinical care and remote monitoring suggest that some acute illnesses no longer require intravenous therapy and inpatient hospitalization. Objective: To describe outcomes of patients receiving care in a new, outpatient, virtual, home-based acute care model called Safer@Home. Design, Setting, and Participants: This retrospective cohort analysis, conducted from September 1, 2022, through August 31, 2023, included 2466 patients treated at a safety net hospital in Los Angeles County for 10 core illnesses and 24 other acute illnesses for which patients are commonly hospitalized. Exposure: Outpatient, home-based, acute care with virtual monitoring and clinic visits in lieu of inpatient or in-home care. Main Outcomes and Measures: The primary measure was hospital length of stay. Secondary measures included all-cause mortality, 30-day readmission, return urgent care visit rates, and return emergency department (ED) visit rates. Results: Safer@Home provided care to 876 patients (mean [SD] age, 54.0 [14.5] years; 541 men [61.8%]) during the study period, compared with a cohort of 1590 patients (mean [SD] age, 52.3 [19.6] years; 901 men [56.7%]) with matching diagnoses who received standard, hospital-based care. Safer@Home patients had significantly shorter mean (SD) lengths of inpatient stay than the comparison cohort (1.3 [2.0] vs 5.3 [10.4] days; P < .001), totaling 3505 bed-days avoided (mean [SD], 4.0 [10.6] bed-days saved per patient), with no significant difference in all-cause mortality at last follow-up (2.6% [23 of 876] vs 4.0% [64 of 1590]; P = .07). Safer@Home patients and control patients also had no significant difference in the proportion experiencing 30-day hospital readmission (19.9% [174 of 876] vs 16.7% [266 of 1590]; P = .06). As intended, more Safer@Home than control patients had at least one 30-day return urgent care visit (37.3% [327 of 876] vs 5.2% [82 of 1590]; P < .001). In contrast, the Safer@Home and control cohorts did not significantly differ in experiencing at least one 30-day return ED visit (15.2% [133 of 876] vs 12.5% [199 of 1590]; P = .06). Safer@Home patients had significantly fewer mean (SD) total 30-day return ED visits per patient than control patients (0.19 [0.50] vs 0.21 [0.85]; P < .001). Conclusions and Relevance: In this cohort study, patients receiving acute, virtual, home care with remote monitoring and as-needed return urgent care visits had markedly shorter hospital stays than patients receiving standard inpatient hospital care, with no significant increase in mortality, ED revisits, or return hospitalizations. This new care model is promising for systems that cannot staff Medicare-compliant hospital-at-home visits.

Indexed as

Home Care ServicesLength of StayAcute DiseaseAdultAgedFemaleHumansLos AngelesMaleMiddle AgedPatient ReadmissionRetrospective StudiesTelemedicine

Identifiers

PMID39589741
PMCPMC11600231

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.