Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Yam CP, Yeung MP, Yu KK, Tai ML, Leung SK
Affiliation :
Jockey Club Integrated Rehabilitation Day Center (JCIRDC), Department of Rehabilitation, Kowloon Hospital (KH)
Introduction :
The District Health Centers (DHC) are set up by the government with the aim to enhance public awareness of disease prevention and promote self‑management of health through public‑private partnership, providing support for the chronically ill to relieve the pressure on specialist and hospital services. With an ageing population in Hong Kong, the need for rehabilitation service is expected to further increase in the coming future. As a regional rehabilitation day center providing specialized rehabilitation programs to stroke and hip fracture patients, we foresee a coordinated effort in establishing a new referral pathway to DHC could facilitate community rehabilitation to our patients, can improve the medical social collaboration (MSC) and fulfil the aims of DHC as advocated by the government.
Objectives :
To evaluate patient’s needs in community rehabilitation, their acceptance, expectations and obstacles in participation in community-based training programs (DHC programs) for improving our current service model and improvements in the referral mechanism.
Methodology :
A semi-structured interview was designed with reference RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework and CFIR (Consolidated Framework for Implementation Research). The survey was conducted for all the new patients with referral diagnosis of stroke or hip fracture to JCIRDC from November 2022 to April 2023 at their first attendance in JCIRDC. Outcome measurement: The responses on each question were summarized and analyzed according to the CFIR domains.
Result & Outcome :
Total 57 patients were interviewed (61.4% >60 years old; 9% aged 31 - 40 years old); 86% expected further rehabilitation training after completed JCIRDC program; 69% didn’t knew about any available rehabilitation options in ; 64% appreciated if information about community rehabilitation information/DHC could be provided by JCIRDC, which would increase their understanding and willingness to enroll in community rehabilitation; 86% reflected possible obstacles (in descending order): cost of transportation service (50.9%), inconvenient center locations (31.6%), cost payment for service (24.6%), lack of referral assistance (19.3%), insufficient information available (21.1%), peer experience and reputation of the service (14%). Conclusion: Our patients are in general with high expectations and acceptance in community rehabilitation including DHC service. Based on the reflections from our patients, HA day rehabilitation centers can consider to play a more active role to connect with DHCs and serve as a service point to assist referrals, providing information to patients, feedbacks to DHCs for service modulations and improvements. This can also help to consolidate MSC and raise public awareness and participation in community rehabilitation training.
