Authors (including presenting author) :
Mo KC(1), Ng MW(1), Yeung KM(1), Poon KH(1), Tsang HC(1), To YL(1)
Affiliation :
(1)Physiotherapy Department, North District Hospital (NDH)
Introduction :
The Planning Department of Hong Kong SAR projects a 41% growth in the ageing population in North District from 309,600 (2021) to 435,600 (2031). To relieve in-patient care demand and maintain healthcare sustainability, service models of rehabilitation re-orientation by enhancing community-based care are warranted
In October 2023, a structured post-hospitalization outreach physiotherapy program (“Rehab@Home”) was established in NDH to support geriatric patients. The program targets patients aged 60 or over, with deterioration in physical abilities compared to pre-morbid status. After in-patient pre-discharge planning, patients would be included in a 4-week home-based training program, physiotherapists visit patients for assessment and formulating physical training plan with goals in skills hardening and self-management empowerment.
Objectives :
To evaluate the clinical effectiveness of a newly established outreach physiotherapy program (“Rehab@Home”) in NDH.
Methodology :
With a retrospective pre-post design, clinical data of patients who received “Rehab@Home” program in October 2023 to October 2024 was analyzed.
Result & Outcome :
A total of 184 patients (mean age: 77.4±12.6, 53% male) participated in the “Rehab@Home” program, with the majority being deconditioning (39.2%) and neurological (19.6%) cases. The mean length of stay in medical wards (76% from acute and 24% from convalescence) was 17.5±19.8 days.
Patients started the “Rehab@Home” program 2.7±3.0 days post-discharge and participated in 3.1±2.9 sessions. Upon completion, statistically significant improvements in functional mobility and ambulatory status were demonstrated. The mean Elderly Mobility Scale (EMS) score increased from 10.5±6.4 to 11.9±6.7 (p<0.001), with a 19.2% increase in patients achieving independent functional mobility. The Modified Functional Ambulatory Category (MFAC) also improved (p<0.001), with a significant increase in unassisted walkers (53.9% to 68.9%). Majority of patients (84.8%) stayed stably in the community within 28-day post-discharge.
Multiple linear regression revealed that physiotherapy home visit times (p<0.001) and the date of program start from hospital discharge (p=0.027) were significant predictors of changes in EMS scores, and accounting for 11.5% of the variance. The multiple R (0.339) was shown to be statistically significant (p<0.001). Each additional physiotherapist visit was associated with a 0.24-point increase in EMS score, while starting the program one day earlier was associated with a 0.184-point increase in EMS score.
The "Rehab@Home" program demonstrates the effectiveness of early domiciliary physiotherapy interventions in improving functional mobility and ambulatory status in post-hospitalized geriatric patients. These findings support the implementation of early home-based physiotherapy programs to enhance patient outcomes and reduce healthcare utilization.
