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
Introduction :
Hong Kong's growing ageing population is expected to increase the demand for in-patient care. To address this, the Hospital Authority (HA) has planned community-based care as a strategy to achieve the goal of providing smart care and fulfilling HA mission of helping people stay healthy in the community.
A structured outreach chest physiotherapy program ("CPT2") was launched in North District Hospital (NDH) in October 2023. The program targets post-discharge geriatric patients aged 60 or over, with sputum retention or home oxygen therapy needs, aiming to support their transition to community-based care. Physiotherapists visit patients within 3 days of hospital discharge to assess and develop a personalized chest physiotherapy plan, focusing on skills transfer for long-term community care.
Objectives :
To evaluate the clinical effectiveness of a newly established community outreach chest physiotherapy program (“CPT2”) in NDH.
Methodology :
Clinical data of patients who received “CPT2” program from October 2023 to October 2024 was analyzed retrospectively.
Result & Outcome :
The chest maintenance group comprised 48 patients (mean age: 81.2±10.2 years, 54% male), with the majority being cases of pneumonia and sputum retention. Patients stayed in acute medical wards for 8.5±4.8 days (88%) or convalescent medical wards for 14.8±10.1 days (12%). The "CPT2" program was initiated 2.4±2.0 days post-discharge, and patients participated in 6.2±5.9 sessions. Notably, 60.4% of patients remained stable in the community within 28 days post-discharge. Among those without 28-day re-admission, 35.4% (n=17) had stabilized chest conditions, 12.5% (n=6) required referral to day rehabilitation or other outreach programs, and 12.5% (n=6) received intensive caregiver training for skills transfer.
The home oxygen therapy management group comprised 59 patients (mean age: 81.7±10.4 years, 41% male), with the majority being respiratory and cardiac cases. Patients stayed in acute medical wards for 15.9±10.9 days (86%) or convalescent medical wards for 43.3±30.3 days (14%). The "CPT2" program was initiated 2.4±6.3 days post-discharge, and patients participated in 2.6±2.4 sessions. Encouragingly, 71.2% of patients remained stable in the community within 28 days post-discharge. Among those without 28-day re-admission, 37.3% (n=22) had stabilized conditions with home exercises prescribed, 5.1% (n=3) required referral to a respiratory-specific outreach program, and 28.8% (n=17) received intensive caregiver training for skills transfer.
To conclude, chest conditions and home oxygen therapy management were managed by early "CPT2" program provided by outreach physiotherapists, and the program demonstrated effectiveness in supporting geriatric patients and enhancing case stability and prevent avoidable re-admission.
