{
  "abstract": "Background: NCDs are the leading cause of premature mortality, hitting hardest in middle-income countries with fragmented health systems. Long-term real-world evidence from Latin America remains scarce, and most available studies rely on short follow-up or inadequate statistical control, limiting interpretability. This study evaluates longitudinal clinical and behavioral trajectories under a structured hybrid care model in a high-risk multimorbid population.\n\nMethods: Retrospective pre-post observational study using electronic health records linked to a telemonitoring platform at a tertiary centre in Medellín, Colombia (n = 319; ≥3 years follow-up). Participants had hypertension, type 2 diabetes, and/or dyslipidemia. Within-patient changes were assessed using paired tests, McNemar/Bowker tests, and mixed-effects models. Multiple testing was controlled using false discovery rate (q-FDR). All findings were interpreted as longitudinal associations.\n\nResults: Median age 63 years, 73.7% women, 96.9% multimorbidity. Therapeutic target achievement rose from 21.9% to 52.7% (95% CI 47.1–58.3). Weight decreased 4 kg, systolic BP 6 mmHg, diastolic BP 5 mmHg (all q-FDR<0.05). High cardiovascular risk declined 8.8 percentage points, with 29.2% reclassified to lower-risk strata. Adherence improved ∼34 percentage points. Reductions observed in diabetic ketoacidosis and myocardial infarction. Three-year mortality was 2.5%.\n\nConclusions: Sustained hybrid care was associated with meaningful improvements in cardiometabolic control, adherence, and risk redistribution in a real-world high-risk population. Findings support: expanding hybrid models for chronic disease management; integrating digital and in-person care pathways into policy; and strengthening surveillance through longitudinal real-world data. This study also offers a replicable methodological framework for rigorous digital health evaluation in middle-income settings.\n\nKey messages: • A hybrid care model at Latin America’s first digital hospital achieved therapeutic target doubling and cardiovascular risk reclassification in 29% of high-risk multimorbid adults over three years.\n\n• A scalable hybrid telehealth model improved adherence by 40 percent and shifted nearly one third of patients to lower cardiovascular risk categories.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "K Saldarriaga Bedoya"
    },
    {
      "name": "E Buskens"
    },
    {
      "name": "C Carvajal Espinosa"
    },
    {
      "name": "GR Ariza S"
    },
    {
      "name": "Ml Lahr"
    },
    {
      "name": "H Moncayo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5wm1w24nhb79f.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.1193",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698555/",
  "id": "5wm1w24nhb79f",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.1193",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "6. Poster Displays"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "heading",
      "DE. Digital health and Artificial Intelligence"
    ],
    [
      "openalex",
      "2739|Telemedicine and Telehealth Implementation"
    ]
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  "openalex": "W7223706393",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13698555/pdf/?tool=EBI",
  "pmcid": "PMC13698555",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/5wm1w24nhb79f.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:25Z",
      "native_id": "PMC13698555",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.1193"
    },
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "PMC:PMC13698555",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13698555"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Telemedicine and Telehealth Implementation",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Hybrid telehealth outcomes at Latin America’s first fully digital hospital",
  "title_text": "Hybrid telehealth outcomes at Latin America’s first fully digital hospital",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:35:24Z",
  "url": "https://research.draconitic.com/paper/5wm1w24nhb79f",
  "venue": "The European Journal of Public Health",
  "versions": []
}