Dengue@Home: evaluation of a hospital in the home pathway for management of adults with dengue fever.

BACKGROUND

The rising incidence of dengue in popular travel destinations for Australians is increasing the burden on local healthcare systems. Since hospital-based monitoring consumes significant resources, alternative models of care are needed.

AIM: To evaluate a hospital-in-the-home (HITH) monitoring pathway for dengue ('Dengue@Home') at a quaternary hospital in Melbourne, Australia.

METHODS

Adults with confirmed acute dengue (positive NS1 antigen, PCR or IgG seroconversion) were considered for HITH if aged <65 years. Patients with dengue warning signs, severe dengue, significant comorbidities, co-infection, pregnancy, an unsafe home environment, poor oral intake or platelet count <100 × 109/L within 72 h of fever onset were generally managed as inpatients. The pathway provided daily nursing visits, serial pathology and telehealth medical reviews. A retrospective review of all dengue cases during the programme's first 19 months (June 2024-January 2026) was undertaken to assess utilisation and safety.

RESULTS

Of 39 patients with dengue, 12 (31%) were admitted to HITH, 15 (38%) to an inpatient ward and 12 (31%) were discharged home. The average HITH length of stay was 4.3 days. Of the HITH patients, 92% (n = 11) had a complete assessment of dengue warning signs, and none received NSAIDs after admission template completion. One patient (3%) was readmitted from HITH with epistaxis and transaminitis. The programme saved an estimated 64 799 Australian dollars (AUD) in the 2024-2025 financial year, assuming each HITH admission represented an avoided inpatient admission of equivalent duration.

CONCLUSION

Home-based management of returned travellers with dengue is feasible and safe and reduces unnecessary hospital admissions.