S.Y.LU1, J.H.MO2, S.YOON2, L.L.LOW3
SingHealth Community Hospitals1, Duke-NUS Graduate Medical School2, Singapore General Hospital3
The COVID-19 pandemic affects the process of routine care for patients with pre-existing medical conditions. We aimed to explore the impact of COVID-19 restriction measures on discharge planning and continuum of care in vulnerable patients from the perspectives of multi-stakeholders.
We conducted focus group discussions and in-depth interviews with healthcare workers, patients and their caregivers and government officials in Singapore. All interviews were audio-recorded, transcribed verbatim and thematically analysed using NVivo 12.
A total of 53 participants took part in the study, of which 43 were healthcare professionals. Many participants stressed the vital role of community services in meeting the care needs of vulnerable older patients throughout the discharge process and into the community. Most felt that suspension or curtailment of such services caused delayed and inadequate assessment of discharge needs and planning, and consequently compromised patients’ physical and mental wellbeing and caregiver burden. Participants suggested the need for clearer communication of guideline from authorities, improved intersectoral collaboration, shared responsibility of patient care through community engagement and novel models of care including telemedicine. Revisiting the definition of essential services with all stakeholders involved would allow for better response to evolving needs on the ground.
Limited community services as a result of COVID-19 restriction measures created a challenge of ensuring safe discharge of vulnerable patients and disruption of care continuity in the community. Findings shed light on the need for developing optimal care models to support vulnerable patients within and beyond the pandemic.