Authors (including presenting author) :
Leung KKL, Lau MHL, Lam CPY, Chau RMW
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Stringent infection control measures, such as maintaining social distancing and minimizing physical contact, have been implemented in all Outpatient Physiotherapy(PT) Departments of Hospital Authority since the outbreak of coronavirus. In combating the pandemic, scaling down of non-urgent clinical services and staff deployment presented big challenges for out-patient physiotherapy services. Various administrative measures including cautious triage and services scheduling is essential in assuring timely PT services to patients presenting with urgent/semi-urgent priority and maintaining decent services provision to needy patients. Service monitoring is vital for informing reasonably practicable services provision during pandemic.
Objectives :
To monitor the impact of scaled-down outpatient physiotherapy services amid the pandemic on pain reduction, self-perceived recovery, and the number of attendances in patients with musculoskeletal conditions.
Methodology :
A retrospective longitudinal case review has been conducted to collect demographic and clinical data from patients discharged from the PT department. Data of patients with musculoskeletal conditions with the first appointment attended during the fifth wave of pandemic(1.1.2022 to 30.9.2022) were extracted for outcome comparison with pre-pandemic baseline(1.1.2019 to 30.9.2019).
Result & Outcome :
Data of 3,186 discharged outpatients(pre-pandemic:2,221;pandemic:965) were analyzed. Patients in both periods achieved statistically significant and clinically meaningful pain reduction after physiotherapy(p<0.001) in favour of prepandemic group with greater pain alleviation(Pre-pandemic:mean=4.17±2.06 versus Pandemic=3.61±2.16;p<0.001). Similar finding was seen in self-perceived recovery(Pre-pandemic:mean=:68.66±21.85% versus Pandemic=64.27±22.22%;p<0.001). The average attendance was decreased by 3.84 sessions(Pre-pandemic:mean=14.56±11.41sessions versus Pandemic=10.72±4.05sessions;p<0.001) during pandemic. The treatment outcome was not related with number of attendances nor triage categories at either time period(r0.1; p<0.01).
Our findings reflected that during pandemic, patients preferred earlier discharge with less treatment sessions received from hospital based program upon achieving clinically important relief of pain and satisfactory recovery. Nonetheless, decreased patient contact time might impact the self-perceived recovery. In accord with previous literature, both physical and psychosocial aspects of health were associated with recovery1-2 which can be addressed through patient empowerment.3-4 Additionally, the fear of contracting virus might help explain the phenomenon of decrease in outpatient attendances since the perception of medical facilities as “high risk” areas deters patients from hospital visits after balancing infection risks and treatment benefits.5 In summary, the administrative measures employed was effective in assuring timely PT services and maintaining decent services provision to needy patients without severe impact on patient’s treatment outcomes.
