Authors (including presenting author) :
Leung KKL, Lau MHL, Lam CPY, Chau RMW
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Out-patient physiotherapy(PT) service was consistently in high demand with steady increasing trend. Musculoskeletal pain was the main referring reason for the service and has been increasing globally in the past decades due to population growth, ageing and sedentary lifestyles. Though most musculoskeletal conditions are self-limiting, about one-fifth of patients develop chronic pain, which has negative impacts on patients’ quality of life and leads to substantial financial burdens to society. In face of the pandemic with corresponding re-deploying resources, the Out-patient PT service subjects to challenge of scaled down capacity for escalating service demands. It is imperative to provide timely services to minimize the transition from acute to chronic pain for needy patients. A structured triaged physiotherapy program has been implemented in the PT Department of Kowloon Hospital since 2015. All patients, regardless of the number of musculoskeletal conditions referred, were prioritized into three categories: Urgent(P1), Semi-urgent(P2) and Routine(R), according to the urgency of patients’ conditions.
Objectives :
To review the effectiveness and efficiency of the triaged physiotherapy program in pain reduction and recovery in patients with multiple musculoskeletal conditions.
Methodology :
A retrospective longitudinal survey was conducted to collect demographic and clinical data from patients discharged from the Out-patient PT of Kowloon Hospital since 1.9.2016. Data of patients with multiple musculoskeletal conditions were extracted.
Result & Outcome :
The current review included 4,944 patients with multiple musculoskeletal conditions, in which 9.08%, 23.87% and 67.05% were allocated to P1, P2 and R categories respectively, with mean waiting times of 7.73±3.66 days, 38.39±12.60 days and 104.43±39.48.66 days(p< 0.001). Number of attendances (mean:13.88±4.57 sessions; p=0.202) were comparable among the triage groups. Low back pain, followed by knee, neck and shoulder pain were the most common referred conditions. The average number of musculoskeletal conditions referred is 2.52. All groups demonstrated statistically and clinically significant pain reduction after physiotherapy interventions (p< 0.0001) with no between-group difference found (p=0.242). The mean percentage of recovery was 79.05±10.81%, with no between-group difference found (p=0.149).
Compared with reviews conducted since 2016, the number of attendances per episode for patients with multiple musculoskeletal problems reduced from 16.60±7.8 in 2016 to 14.87±7.03 in 2020. The percentage of recovery increased from 68.52±19.99 in 2016 to 78.14±11.06 in 2020. There was marked improvement in the effectiveness and efficiency of PT services. Implementation of appropriate triage system assisted rational manpower allocation in coping with the service challenges through effective care path in meeting patient’s needs within deployed resources in public setting.
