Authors (including presenting author) :
Cheung GCM(1), Chan JSP(1), Chak NNT(1), Chau RMW(1), Chan ACM(2)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital, (2)Physiotherapy Department, Queen Elizabeth Hospital
Introduction :
Community-based Physiotherapy for Integrated Care and Discharge Support for Elderly Patients(ICDS) sustained the supportive and gate-keeping roles for frail elders who were also severely impacted by COVID-19 pandemic.
Objectives :
To identify the changes of physical profile of patients receiving ICDS during pandemic for service modification in supporting safe stay of frail elders in community.
Methodology :
A 6-year retrospective review segregating Pre-COVID group_I(2017-2019) versus COVID-group_2(2020-2022) was conducted in patient characteristics and outcomes of ICDS referring for physiotherapy. The scores of Modified-Functional-Ambulation-Classification(MFAC) measuring functional mobility, Modified-Barthel-Index(MBI) measuring physical disability, were captured at initial and final sessions of home-visits(HV). The total number of HV, High-Admission-Risk-Reduction-Program-For-Elderly-Score(HARRPE), re-admission rate was analysed using SPSS 23.0 & non-parametric data exploration.
Result & Outcome :
Totally 819 cases(group1_N=453;group2_N=366) were reviewed. No difference was determined in age(group_1=81.03±7.99;group_2=82.09±8.56,p=0.07). 35.20%of group_1 and 43.7%of group_2 was female. Higher HARRPE score(group_1=0.25±0.15;group_2=0.22±0.15,p=0.01) and better initial MBI(group_1=84.89±16.42;group_2=78.99±23.93,p=0.00) was found. 85.4%patients at group_1(N=453) and 74.8%(N=366) at group_2 could walk under supervision or independently(initial MFAC V-VII). Baseline pre-intervention functional conditions at 1stHV were better before Pandemic. Both groups responded to Physiotherapy with significant within-group physical improvement(group_1-MBI improved from 84.89±16.42 to 89.13±14.16 versus group_2 from 78.98±23.96 to 84.51±22.01, p<0.05) but no significant between-groups difference(N=819,p=0.059) of the two studied time periods. The number of HV was 0.49 more attendance during pandemic(group_1=5.85±3.15;group_2=6.34±3.91;p<0.05). The physical improvement(MBI score) was related to the number of HV(rs=0.42,p=0.000). Higher readmission rate(58.8%) was reported in group_1 versus group_2(24.7%).
Although the frail elders of the pandemic group demonstrated a lower pre-intervention physical and mobility function, their treatment response showed comparable improvement after a course of Physiotherapy during pandemic. Our findings supported that Physiotherapy continue to contribute to the supportive and gate-keeping roles of the ICDS program in facing bigger challenges from patient and contextual factors during pandemic.
