Alternative models and pathways of care for adults with low back pain to reduce hospital admission and length of stay: a scoping review.

The purpose of this scoping review is to systematically map and synthesise the evidence on hospital-based service delivery interventions and models of care designed to reduce hospital admission rates and/or length of stay for adult patients presenting with low back pain. Service delivery interventions are defined as changes to the organisation, structure, or delivery of care at the hospital level, rather than individual clinical treatments or policy level reforms. This review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodological guidance for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The review will examine the types and characteristics of service delivery interventions implemented by hospitals, the patient populations eligible for these interventions, and their reported effects on health service outcomes (including hospital admission rates, length of stay, readmissions, and healthcare utilisation), patient health outcomes, and adverse events. Where available, qualitative evidence on the experiences and acceptability of these interventions among patients, carers, and clinicians will also be summarised. The expected outcomes of this project include a comprehensive overview of existing hospital-based service delivery interventions for LBP and clarification of which models of care show promise in reducing hospital admission and length of stay. The findings will inform future implementation and evaluation studies aimed at improving the appropriateness and value of hospital care for patients with low back pain and may support health services and policymakers in designing and refining hospital-based models of care.