By Tan Tock Seng Hospital
Hip fracture is a major public health concern in Singapore. It is projected that persons aged 50 years and above with hip fracture will increase 2.5 times from 4,477 in 2018 to 15,806 in 20501. Fortunately, with good care management, it can help to restore patients’ functional ability and prevent other potential health issues (e.g. fall risks).
Most hip fracture patients go through multiple care settings through their care and rehabilitation journey – as illustrated in diagram 1 below:
To encourage greater take-up rates for community rehabilitation, the
Hip Fracture Bundle Plus Scheme was started. A collaborative venture by Tan Tock Seng Hospital (TTSH) and its community partners and with support from TTSH Charity Fund, this pilot initiative aims to provide financial support and increase patients’ access to community rehabilitation at Day Rehabilitation Centres (DRCs).
DRCs are community-based centres that offer structured rehabilitation services which ensure that patients are able to continue their rehabilitation journey after discharge from hospital. The partnering DRCs are Ang Mo Kio-Thye Hua Kwan Hospital, AWWA Rehab and Day Care Centre, Ren Ci Community Hospital and SPD @ Toa Payoh.
Since the start of the programme in July 2020, approximately 30% of all eligible patients discharged from TTSH and participating community hospitals have enrolled into the programme and 51 patients have successfully completed their therapy at the DRCs2. All the enrolled patients experienced significant improvement in their functional outcomes, with an average of 12% improvement in their Modified Barthel Index (MBI) scores at the end of their therapy sessions, and a 42-point MBI score improvement at their 6-month post-fracture
Beyond clinical benefits, the Hip Fracture Bundle Plus programme has strengthened partnership between TTSH and community partners to ensure that we continue to work
towards a seamless and holistic care for our patients. The efforts invested in the programme lay the foundation for future initiatives, such as One Rehab, that coordinates health and community services for the population.
Cheung, S.B., Ang, S.B., Chadha, M., Chow, E.S., Chung, Y.S., Hew, F.L., Jaisamrarn, U., Ng, H., Takeuchi, Y., Wu, C.H., Xia, W., Yu, J., Fujiwara, S. (2018). An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study.
Osteoporos Sarcopenia, 4(1), 16-21.
As of June 2021