Caruana E L, Kuys S S, Clarke J, Brauer S G
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
Physiotherapy Department, St Andrew's War Memorial Hospital, Brisbane, Australia.
Physiother Res Int. 2018 Apr;23(2):e1701. doi: 10.1002/pri.1701. Epub 2018 Feb 5.
The impact of staffing model providing weekend physiotherapy rehabilitation has not been evaluated. This study aims to determine the impact of staffing a weekend rehabilitation service with physiotherapists currently working in rehabilitation compared to acute hospital physiotherapists, on length of stay (LOS), functional independence and gait and balance, and to determine the impact on neurological, orthopaedic, and reconditioning diagnostic groups.
A prospective cohort study with historical control was completed in a private, metropolitan Australian rehabilitation unit. All participants admitted to the rehabilitation unit over two, 20-week periods in 2011 and 2012 were included. Weekend physiotherapy was provided by physiotherapists working in rehabilitation in 2012 (intervention) and physiotherapists working in the acute wards in 2011 (control). Outcomes included LOS, Functional Independence Measure (FIM), and gait and balance measures.
Overall, there were 504 participants; 234 in 2012 and 270 in 2011. No difference was found in LOS between staffing models (mean difference-1.5 days, 95%CI -4.4 to 1.3). Greater FIM change (mean difference 3.5, 95%CI 0.3 to 6.7) and efficiency (FIM change/LOS: mean difference 0.3, 95%CI 0.1 to 0.5) were found with rehabilitation compared to acute staffing. There was no between-group difference in gait or balance performance. When diagnostic groups were compared, no difference in LOS was found between staffing models. Participants with an orthopaedic diagnosis had a significantly greater FIM change (mean difference 3.8, 95%CI 0.4 to 7.1), whereas FIM efficiency was improved in neurological (mean difference 0.4, 95%CI 0.1 to 0.7) and orthopaedic populations (mean difference 0.3, 95%CI 0.03 to 0.5) with rehabilitation staffing.
Staffing a weekend rehabilitation service with physiotherapists currently working in rehabilitation influences functional independence. Different diagnostic groups appear to respond differently.
提供周末物理治疗康复服务的人员配备模式的影响尚未得到评估。本研究旨在确定与急症医院物理治疗师相比，配备目前从事康复工作的物理治疗师提供周末康复服务对住院时间（LOS）、功能独立性以及步态和平衡的影响，并确定对神经科、骨科和康复诊断组的影响。
在澳大利亚一家大都市的私立康复机构完成了一项采用历史对照的前瞻性队列研究。纳入了2011年和2012年两个为期20周期间入住该康复机构的所有参与者。2012年由从事康复工作的物理治疗师提供周末物理治疗（干预组），2011年由急症病房的物理治疗师提供（对照组）。结局指标包括住院时间、功能独立性测量（FIM）以及步态和平衡测量。
总体而言，共有504名参与者；2012年有234名，2011年有270名。两种人员配备模式在住院时间上未发现差异（平均差异为-1.5天，95%置信区间为-4.4至1.3）。与急症人员配备相比，康复人员配备在FIM变化方面更大（平均差异为3.5，95%置信区间为0.3至6.7）且效率更高（FIM变化/住院时间：平均差异为0.3，95%置信区间为0.1至0.5）。步态或平衡表现方面组间无差异。比较诊断组时，两种人员配备模式在住院时间上未发现差异。骨科诊断的参与者FIM变化显著更大（平均差异为3.8，95%置信区间为0.4至7.1），而康复人员配备在神经科（平均差异为0.4，95%置信区间为0.1至0.7）和骨科人群（平均差异为0.3，95%置信区间为0.03至0.5）中FIM效率有所提高。
配备目前从事康复工作的物理治疗师提供周末康复服务会影响功能独立性。不同诊断组的反应似乎有所不同。
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