Pahirden, Gülnigar Renee;
Stefler, Denes;
Jayatunga, Wikum;
(2025)
The equity of virtual ward models of care across sociodemographic groups in the United Kingdom – a systematic review.
Journal of Integrated Care: Practical evidence for service improvement
10.1108/JICA-03-2025-0018.
(In press).
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Abstract
Purpose: Virtual Wards (VWs) or “Hospital-at-Home (HAH)” services, deliver hospital-level care in patients' homes by integrating remote monitoring and treatment, facilitating early discharge and reducing inpatient admissions. However, the equity of these care models in the UK remains unclear. This paper aims to synthesise existing evidence on VW's effectiveness, suitability and acceptability across diverse sociodemographic groups using the PROGRESS-Plus equity framework. // Design/methodology/approach: Systematic literature search of PubMed, CINAHL-PLUS (EbscoHost) and MedRxiv databases was conducted, alongside grey literature from government and NHS sources. Eligible studies were appraised using the Mixed Methods Appraisal Tool and findings were synthesized narratively. // Findings: A total of 8,011 records were identified, with seven studies and three government reports included in the final analysis. Using the PROGRESS-Plus framework, the review found that race/ethnicity/culture/language, socioeconomic status and occupation, social capital, age, and health status and comorbidities shaped the effectiveness, suitability and acceptability of VWs. Barriers included cultural and communication mismatches, inadequate housing, lack of caregiving support, digital exclusion among older adults and reduced benefit or engagement for those with complex health needs. Targeted interventions are needed for equitable VW implementation across the UK. // Originality/value: This is the first UK-based systematic review to examine the equity implications of VW implementation using the PROGRESS-Plus framework. While VWs offer system-wide benefits, there is a need for inclusive design and targeted interventions to ensure equitable access and outcomes across all population groups.
| Type: | Article |
|---|---|
| Title: | The equity of virtual ward models of care across sociodemographic groups in the United Kingdom – a systematic review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1108/JICA-03-2025-0018 |
| Publisher version: | https://doi.org/10.1108/jica-03-2025-0018 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Virtual wards, Hospital-at-Home, Health inequity, UK |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10217387 |
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