Page 120 - Hospital Authority Convention 2018

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2018

F1.7 Better Manage Growing Demands 10:45 Room 421

Enhanced Home and Community Care Service Reduces Hospital Utilisation and Promotes Aging in Place among
Frail Elderly in Hong Kong
Wong WY, Liu H, Mak HM, Mak R, Chan Y, Kwok N, Chan R
Nursing Services Division, Wong Chuk Hang Hospital, Hong Kong

Introduction
In face of the aging population, there is an increasing need to shift the healthcare provision from hospital to community care
service. An Enhanced Home and Community Care Service (EHCCS) has been established by the Hong Kong Government
since 2001. Nursing outreaching team of WCHH has been collaborating with non-governmental organisations to provide
multidisciplinary and community-based care to elderly living in the community.

Objectives
To evaluate the effectiveness of EHCCS on the reduction of hospital utilisation among frail elderly so as to promote aging in
place.

Methodology
Monday, 7 May 2018 Primary outcomes are: rate of emergency department attendances (EDA), rate of unplanned hospital admission (UHA) and
A quasi-experimental study was carried out to compare the hospital utilisation of frail elderly one year before and after
enrolled into the programme. Home visits and on-site nursing care by registered nurses of WCHH were provided regularly
with other community-based services.

the hospital length of stay (LOS)
Rate of private nursing home placement among all service users over the one-year period was analysed. Data were extracted
from hospital records and analysed by a paired-samples T-test.
Results
Between February 2016 and January 2017, 90 service users were eligible. Result shows a reduction in EDA (20%), UHA (6%)
and a significant reduction in LOS (66%) (p<0.01).
Users have been receiving the service for an average of 26 months. Up to 95% could remain in the community, while only 2.5%
were admitted to private nursing homes mainly due to sudden unavailability of primary caregivers.

The EHCCS with nursing support is effective in reducing hospital utilisation and need of inpatient care. This could possibly
reduce healthcare expenditure in the long run.
Despite the fact that frail elderly do need acute hospital admissions, the combination of family and familiar environment along
with skilled nursing, professional healthcare, and individualised social services can allow elderly to live with frailty securely
in their own home. Carer support can enhance family cohesion and assist carers in overcoming barriers to caring the elderly.
Further improvement and strengthening of the collaboration and communication between health and social care sectors
would better optimise delivery of care.

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