Authors: (including presenting author): :
Wan S(1), Chung KM(1), Chung KY(1), Ko WC(1), Lam CS(1), Lee WS(1), Leung WK(1), Li KH(1), Mak YT(1), Tung LH(1), Siu CY(1), Tse CS(1), Wong LC(1), Chan LC(1), Mak MY(1)
Affiliation: :
(1)Physiotherapy Department, Tuen Mun Hospital, Hospital Authority
Keyword 1: :
Service Efficiency
Keyword 2: :
Service Sustainability
Keyword 3: :
Surging Demand
Keyword 4: :
Stratified Care Model
Keyword 5: :
STarT Back Screening
Keyword 6: :
Low Back Pain
Introduction: :
In alignment with Hospital Authority’s strategic goals to enhance service efficiency and sustainability, stratified care model was adopted to address high volume musculoskeletal conditions such as low back pain (LBP). Physiotherapy Out-patient Department (OPD) of Tuen Mun Hospital (TMH) implemented the stratified care model for LBP patients since Jul 2025. Physiotherapists utilized a validated STarT Back screening tool to stratify LBP patients into low-, moderate- and high-risk subgroups and arranged targeted interventions tailored to the patients of different risk levels. It could reduce over-treatment of low-risk patients and optimize care for the moderate- and high-risk patients.
Objectives: :
(1)To evaluate the stratified care model for LBP patients
Methodology: :
For comparison, LBP patients discharged under stratified care model during Oct to Dec 2025 were included for analysis and compared to those discharged during Oct to Dec 2024. Primary outcomes, including Numeric Pain Rating Scale (NPRS), Numeric Global Rating of Change Scale (NGRCS) and Roland Morris Disability Questionnaire (RMDQ), were collected during initial and final physiotherapy session. Secondary outcome included average physiotherapy sessions attended.
Result & Outcome: :
Results:
477 LBP patients (Low-risk: 38%; Moderate-risk: 36%; High-risk: 26%) discharged under stratified care model during Oct to Dec 2025 (Group A) and 702 LBP patients discharged during Oct to Dec 2024 (Group B) were compared. Two groups of patients did not have significant difference in term of disability level (p=0.118) at baseline. Group A demonstrated significant improvement in NPRS (5.00±2.58 to 2.93±2.29, p< 0.001), NGRCS (0.40±1.75 to 4.42±3.34, p< 0.001) and RMDQ (10.87±6.13 to 7.41±5.48, p< 0.001) within average 4.36±3.23 sessions whereas Group B demonstrated significant improvement in NPRS (5.78±2.29 to 3.06±2.30, p< 0.001), NGRCS (0.22±1.29 to 5.26±2.93, p< 0.001) and RMDQ (11.61±5.75 to 7.90±5.68, p< 0.001) within a longer period (9.15±8.47 sessions). Most importantly, there was no significant difference between two groups of patients in term of the functional improvement (F=0.781, p=0.377). Conclusions:
Stratified care model for LBP patients improved the service efficiency while the clinical outcomes of the patients would not be compromised. This approach could maintain the service sustainability under the surging demand with this evidence-based practice.
