New Health Care Model New Health Care Model --Hospital Services working with Hospital Services working with Community Partners as a Team Community Partners as a Team

Improves Diabetes CareImproves Diabetes CareSiu SC, Wong YS, Lau T, Au S, Wong D, So A, Siu SC, Wong YS, Lau T, Au S, Wong D, So A,

Li E, Wong C, Kam ELi E, Wong C, Kam EDept of Med & Rehab, TWEHDept of Med & Rehab, TWEH

Dept of Med, PYNEHDept of Med, PYNEHDept of Integrated Medical Service, RHTSKDept of Integrated Medical Service, RHTSK

Community Services, HKECCommunity Services, HKECCRN, The Hong Kong Society for RehabilitationCRN, The Hong Kong Society for Rehabilitation

TWGHsTWGHs KoKo Wong Mo Ching Memorial Holistic Healthcare Centre Wong Mo Ching Memorial Holistic Healthcare Centre Diabetes Diabetes HongkongHongkongSt JamesSt James’’ SettlementSettlement

HKEC Symposium on Community Engagement IV 18.4.09HKEC Symposium on Community Engagement IV 18.4.09

Diabetes MellitusDiabetes Mellitus

•• An epidemicAn epidemic

•• 700,000 Hong Kong people affected700,000 Hong Kong people affected

Dire ConsequencesDire Consequences•• Patient sufferings : more than our imaginationPatient sufferings : more than our imagination

–– PhysicalPhysical–– PsychologicalPsychological–– SocialSocial–– FamilyFamily–– WorkWork

Holistic Diabetes Care Holistic Diabetes Care --Beyond the traditional focusBeyond the traditional focus

•• Doctors ConsultationDoctors Consultation

•• DM EducationDM Education

•• Complication ScreeningComplication Screening

We canWe can’’t work alonet work alone

PatientsPoor quality of life

Heavy work load Faithful allies in Diabetes care

Work togetherWork together

Brainstorm meetings/visitsBrainstorm meetings/visits

•• Starting 9/2007Starting 9/2007

•• Hong Kong East Cluster Diabetes ServicesHong Kong East Cluster Diabetes Services

•• NGOs, Hong Kong IslandNGOs, Hong Kong Island

Design Design ProgrammesProgrammes

•• Target Target vsvs–– Psychological supportPsychological support–– Social interactionSocial interaction–– Exercise enhancementExercise enhancement–– Dietary adviceDietary advice

12/2008 : Total 23 12/2008 : Total 23 programmesprogrammes

Hospital DM ServicesHospital DM Services

•• Pamela Pamela YoudeYoude NethersoleNethersole Eastern HospitalEastern Hospital•• RuttonjeeRuttonjee & Tang & Tang ShiuShiu Kin HospitalKin Hospital•• Tung Tung WahWah Eastern HospitalEastern Hospital

Merging Merging programmesprogrammes into into

usual diabetes careusual diabetes care

Merging Merging programmesprogrammes into usual into usual diabetes carediabetes care

•• Identifying suitable patients : Identifying suitable patients : –– Hospital DM Team during doctor/nurse Hospital DM Team during doctor/nurse

consultationsconsultations

•• Refer to NGOs : Refer to NGOs : –– Hospital Patient Resources Centre/DM TeamHospital Patient Resources Centre/DM Team

•• Provision of Services :Provision of Services :–– NGOsNGOs

Community Rehabilitation NetworkCommunity Rehabilitation Network

St James SettlementSt James Settlement

TWGHsTWGHs KoKo Wong Mo Ching Wong Mo Ching Memorial Holistic Healthcare CentreMemorial Holistic Healthcare Centre

Diabetes Diabetes HongkongHongkong

Up to 12/2008Up to 12/2008

•• No of patient referred to NGOs: 948No of patient referred to NGOs: 948

•• No of actual patient attendance at NGOs: 670No of actual patient attendance at NGOs: 670((70.7%)70.7%)

Marathon Training Marathon Training ––Diabetes Diabetes HongkongHongkong/HKEC 10 Km Marathon/HKEC 10 Km Marathon

MrMr Tang M/52Tang M/52

•• BW: 71.1 64.0kgBW: 71.1 64.0kg

•• A1c: 12.0 7.2% A1c: 12.0 7.2%

•• TC: 5.1 TC: 5.1 4.94.9

MrMr Li M/52Li M/52

•• BW: 79.5 75.0kgBW: 79.5 75.0kg

•• A1c: 8.0 6.1% A1c: 8.0 6.1%

•• TC: 6.2 TC: 6.2 5.45.4

Community Rehabilitation NetworkCommunity Rehabilitation Network身心力行身心力行 for for 3 months3 months

MrMr Lam M/58Lam M/58

•• BW: 98.0 93.3kgBW: 98.0 93.3kg

•• A1c: 9.5 6.3%A1c: 9.5 6.3%

Ms Leung F/49Ms Leung F/49

•• BMI: 30.9 28.8BMI: 30.9 28.8

•• A1c: 7.4 6.5% A1c: 7.4 6.5%

Improved self care, oral drugs

HurdlesHurdles

Hospital

Patients

NGOs•Resources•Staff acceptance•Staff acceptance

•Limited resources•Burnt out

• Financial problems• Busy life style• Medical practice culture

Logistic issues

ConclusionsConclusions

•• New culture : merging community services New culture : merging community services into traditional medical care of diabetesinto traditional medical care of diabetes

•• Appears cost effective, many difficulties Appears cost effective, many difficulties though though

•• Resources needed for the new health care Resources needed for the new health care modelmodel

•• More studies are required More studies are required –– outcomes and outcomes and cost effectivenesscost effectiveness

Thank youThank you