Authors (including presenting author) :
Authors for Doctors: Yam CP, Yeung MP, Yu KK Authors for PT: Chan JSP, Chak NNT, Cheung GCM, Wong JTM, Leung KKL Authors for OT: Li TTK, Tsang D, Chan D Authors for Nurse: Tai ML
Affiliation :
The Jockey Club Integrated Rehabilitation Day Centre (JCIRDC), Department of Rehabilitation; Physiotherapy Department, Kowloon Hospital; Occupational Therapy Department, Kowloon Hospital
Introduction :
The Jockey Club Integrated Rehabilitation Day Centre(JCIRDC) was established in January 2022. We have implemented the Medical-Social-Collaboration(MSC) service with District Health Center for our patients, who finished a three-month period of active Physiotherapy and Occupational Therapy in JCIRDC. The eligible patients are referred to DHC for further community-rehabilitation-program (CRP) Some selected cases are recalled for evaluation after training in DHC.
Objectives :
A pilot study to explore the effectiveness of MSC between JCIRDC and DHC through community rehabilitation training program
Methodology :
The study involved patients who received DHC service after three-months of active Physiotherapy and Occupational Therapy in JCIRDC. The post-discharge referrals to DHC for CRP training included cases with stroke and hip-fracture. Patients were selected for re-evaluation after completing CRP in DHC. The outcome measures included: Modified-Functional-Ambulation-Classification-(MFAC), Modified-Rivermead-Mobility-Index(MRMI) and walking distance, Functional Independence Measure (FIM), Modified-Barthel-Index(MBI), and Community Integration Questionnaire (CQI). Theses assessment scores were conducted at discharge in JCIRDC and post DHC CRP training.
Result & Outcome :
A total of 15 patients who underwent stroke rehabilitation and 3 patients for fracture hip rehabilitation in JCIRDC were referred to Wong-Tai-Sin-District-DHC(n=16), Sham-Shui-Po-DHC (n=2) for CRP. The mean age of the patients was 65.61±13.39, and 66.67%(n=12) of them were female. 15 patients were included in data analysis. After the DHC CRP, MFAC showed improvements from category V to VI; MRMI with slight improvements from 31.29±7.41 to 31.41±8.54 and walking distance improved from 36.18±22.19 to 45.76±30.83 comparing with scores upon discharge from JCIRDC. For functional assessment, the FIM score improved from 102.6± 12.671 to 106.4±15.245 (p≤0.05) and CIQ score from 8.38±3.776 to 10.92 ± 4.329, (p≤0.05) and MBI score from 86.73± 11.392 to 90.07±11.32 (p=0.66). These findings reflected that most of our patient’s physical conditions were maintained after DHC training with some aspects showing slight further improvements. Secondary analysis showed only 1 out of 13 patients with unplanned hospital re-admission among stroke patients in 6 months. Patients with less attendance rate in JCIRDC were also shown to achieve similar maintenance effect after DHC training as compared to those with better JCIRDC attendance (range from 10 sessions to 31 sessions). Conclusion: This CRP of DHC may help in maintaining the rehabilitation outcomes achieved by JCIRDC training. MSC ensures better continuity of care for patients after they were discharged from JCIRDC.
