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.