Outcomes following intensive allied health therapy in the acute hospital for trauma patients.

Abstract

The majority of patients hospitalised for trauma survive their injuries, with the quality of the survival potentially influenced by early acute hospital rehabilitation. The aim of this study was to review the outcomes of patients managed under an intensive Allied Health Model of Care (AHMOC) compared to a baseline cohort.

Methods: The AHMOC was commenced in February 2020 on the Trauma ward at Alfred Health for 12 months. The baseline group included patients admitted to the trauma ward in 2019. All patients who were registered by either the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) or the Victorian State Trauma Registry (VSTR). The association between the groups (AHMOC and baseline) and outcomes were assessed using logistic (discharge destination, 12-month return to work) and linear (length of stay (LOS)) regression.

Results: There were 1644 in the baseline group and 1732 in the AHMOC group, of which 70 % and 76 % respectively were discharged directly home from the acute hospital (p value < 0.001). The trauma ward LOS was 4.0 days for each group (p value 0.77). After accounting for confounders, the adjusted odds of discharge home and RTW at 12 months were 53 % (AOR 1.53 95 % CI 1.29, 1.82) and 65 % (AOR 1.65 95% CI 1.24, 2.21) higher for the AHMOC group compared to baseline, respectively. There was also a 6 % reduction in the LOS in the AHMOC group compared to baseline (Adjusted mean difference 6 %; 95 % CI (0.881, 0.999) p value = 0.050).

Conclusion: This study shows an association between an AHMOC for trauma patients with a focus on early and intensive therapy and improved odds of discharge directly home, as well as improved 12 month return to work outcomes.