Authors (including presenting author) :
Chan JSP, Lee SKF, Chow ESL, Wong TFY, Chan MYL, Lee JKY, Chow KKT, Chak NNT, Yu ENL, Chau RMW
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Restorative rehabilitation with 365-day per year coverage(365-day) Physiotherapy for stroke was launched on 1October2019 and was introduced for 2 year in Kowloon Hospital(KH). A positive result from program evaluation is essential for sustaining new service.
Objectives :
The aim of the present study was to investigate the effect of provision of a 365-day Physiotherapy on both functional mobility and activities, stakeholders’ satisfaction and hospital length of stay(LOS) for stroke in KH.
Methodology :
Patients with stroke receiving weekday-rehabilitation conventional service(control) and 365-day restorative Physiotherapy from 1 Oct 2019 to 30 September 2021 in Kowloon Hospital(KH) were recruited. Subjects was included if they had principal-diagnosis of strokeICD9 code ranged from 430-436 and successfully discharged on or before 30 September 2021 and excluded if out-of-range.
The scores of Modified-Functional-Ambulation-Classification(MFAC), Modified-Barthel-Index (MBI), Modified-Rivermead-Mobility-Index(MRMI) were rated by in-charge-Physiotherapist on-admission and at-discharge. The total LOS in KH was assessed.
The recent experiences 365-day Physiotherapy rehabilitation at-discharge were reported by using a simple satisfaction survey towards the new service. SPSS 23.0 was used for data analysis.
Result & Outcome :
Data of 892 discharged-patients with stroke in both 365-day rehabilitation and weekday-conventional-rehabilitation(control) aged 70.02±32.41. 45.9%(N=409) was female. Significant difference of the change score of MFAC among two groups(N=892, p<0.05) including a median progression of 2 categories for 365-day group(N=669) and 1 category on admission to discharge for control group(N=223). 52.6% participants could walk under supervision or independently in 365-day rehabilitation but 5.1% less participants had the same mobility status in control upon discharge.
The LOS of 365-day group was 33.52±26.30 and control group was 34.81±20.09. However, the results of independent samples t-test revealed these differences were non-significant(p≥0.05).
In sub-group of 365-day rehabilitation analysis, outcomes of MBI improved at discharges (p<0.05), from 41.69±24.82(severe dependency) on admission to 64.09±30.36 (moderate dependency) at discharge; MRMI improved at discharges(p<0.05), from 17.39±9.04 on admission to 26.62±11.56 at discharge. High satisfaction rate about the 365-day restorative Physiotherapy was reported by Physiotherapist(98.3%) from satisfied to very-satisfied(S-VS); reported by patient(88.4%, N=669) of S-VS.
Provision of 365-day service for stroke resulted in earlier and better achievement of functional mobility and activities gain within a relatively short LOS. Appreciation of the new service model form the stakeholders were also demonstrated.
