Development of discharge planning system and telerehabilitation system for intermediate care patients

Abstract

Discharge planning and rehabilitation influence readmission, mortality and clinical outcome of intermediate care. This study aimed to  development discharge planning system and telerehabilitation system for caring intermediate patients at Sanpatong hospital. This research and development divided into included in 3 phases of study. 1) situation analysis phase: 15 participants in focus group discussion for searching problem of discharge planning system and rehabilitation system, including solving the problem; 2) implementation phase: Speedy plan and Speedy tele were designed  then they apply for caring to patients; and 3) evaluation phase: we studied in 80 intermediate patients and collected data about mortality and  Barthel activities of daily living. Survival rate analyzed by hazard ratio. Factor affecting activities of daily living analyzed by risk ratio. The results showed discharge planning by using DMETHOD-FP (Diagnosis, Medicine, Environment, Treatment, Health, Outpatient, Diet, Family meeting and Psychology) reduced mortality more than DMETHOD, adjusted HR =0.17 (95% CI 0.04-0.72). Telerehabilitation  increased activities of  daily living score more than conventional rehabilitation, adjusted RR = 2.63 (95% CI 1.59-4.36). Speedy plan application could reduce mortality in intermediate patients. Likewise Speedy tele application could increase physical fitness in intermediate patients.