Authors (including presenting author) :
Kwok PHM(1), Cheung WLI(2), Chan SPC(2), Cheung TYJ(1)(2),Lau FCA(1),Lam CMD(2)
Affiliation :
(1) Occupational Therapy Department, Pok Oi Hospital (2)Occupational Therapy Department, Tuen Mun Hospital
Introduction :
The pandemic of COVID-19 in Hong Kong commenced in early 2020. During the pandemic, thousands of COVID-19 patients had posed different challenges to local health care system. Occupational Therapists provide a wide variety of service ranging from traditional rehabilitation to facilitating safe discharge with tele-care. With the ever changing pandemic situation and limited information on its impact on patients’ health conditions, this study mainly focuses on OT in-patient service for COVID-19 patients and provides insight onto the outcomes with stratification in light of optimizing manpower and resource allocation.
Objectives :
To review NTWC OT service of patients with COVID-19 for outcome driven care service
Methodology :
Patients with “Diagnosis Code (ICD9) 519.8(8)COVID-19” and “hospitalization date and OT attendance date from 1/1/2020 to 31/12/2022” were retrieved from Clinical Data Analysis and Reporting System (CDARS). Only outcomes with paired data were included in this study. Paired t-tests were carried out on MBI and AMT scores to review statistical significance.
Result & Outcome :
2450 COVID-19 patients with 2599 episodes received OT service in NTWC from 1/1/2020 to 31/12/2022. The coverage of OT service was about 23%. The average length of stay during hospitalization was 15.3 days and the average attendance was 5.03 per episode. The treatment intensity was 0.33. The mean MBI score (n=1203) improved from 52.1 to 55.3 with statistical significance (p=0.01). Regarding to the cognitive function, AMT score (n=156) improved from 3.37 to 3.67 with statistical significance (p=0.01). Out of the 809 patients who lived at home before admission, 60 patients (7.42%) were admitted to institution upon discharge. In view of outcome driven care, COVID-19 patients were categorized in four groups according to their initial MBI score (0-20, 21-60, 61-90 and 91-100). Improvement of MBI score was found to be statistically significant in group 0-20 (MBI from 4.9 to 7.3, p=0.00), 21-60 (MBI from 44.1 to 48.8, p=0.00) and 61-90 (MBI from 74.3 to 77.5, p=0.00), with group 21-60 having the greatest pre-post difference (4.7) Regarding to discharge destination, the % of patients who lived at home before admission and changed to institutional care upon discharge were 10.3%, 14.8%, 6.1% and 0% for group <20, 21-60, 61-90 and >90 respectively. Driven by its outcome, emphasis of resource and manpower allocation for COVID-19 patients shall be put on patients with initial MBI score 0-20 and 21-60. Referral to OT is highly suggested for early intervention for COVID-19 patients with initial MBI score 0-20 and 21-60 in view of functional and cognitive improvement and hence, lowering rate of patients admitting to institutions.
