H.N. KHOR1, Y.FOONG1, S.J.J. PEH1, R.K. THAM1, H.L. LIU1, Y.H. ANG1
Khoo Teck Puat Hospital1
This abstract aims to evaluate if the Early Supported Discharge (ESD) – a home-based rehabilitation initiative, can provide an alternative to community hospital rehabilitation at a lower cost with comparable functional outcomes for hip fracture and acute stroke patients.
57 Hip fracture and acute stroke patients who completed the intervention from Jul 2019 to Dec 2020 were compared with a propensity score-matched cohort who transferred to YCH for rehabilitation. The main outcome measures were: 1) Functional improvement as measured by the difference in Modified Barthel Index (MBI) scores of patients pre and post-intervention. 2) cost of intervention from (a) patients’ and (b) health system’s perspective.
The average pre-post difference in MBI was 17.6 for YCH patients and 13.4 for ESD patients. On average, the ESD scheme cost the hospital $2594/patient, 77.1% less than the YCH stay of $11,325/patient. The patient’s ESD average bill size ($483) was 92% smaller than that of the YCH counterpart ($6022).
ESD may be a lower-cost alternative to a community hospital stay. However, a more robust analysis needs to be done to evaluate ESD’s clinical outcomes, patient experience and cost-effectiveness.