The Impact of COVID-19 on Commonwealth Home Support Program (CHSP) dietetic service delivery and outcome
Vicky Weng1, Yilin Wang1, Allison Grech1, Karen Liu2,3, Elise Baker1,2,3 1South Western Sydney Local Health District, Bankstown, NSW, Australia2Western Sydney University, Penrith, NSW, Australia3Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
Abstract
Background: Malnutrition amongst older people is prevalent in the community. Pre COVID-19 pandemic, home visits were provided to the clients referred to the Commonwealth Home Support Program (CHSP) dietetic service. During COVID-19, telehealth was used to minimize transmission risk. This project aimed to investigate clinical outcome differences before and during COVID-19, and clients’ experience on service delivery modes.
Methods: Mixed methods were used- retrospective file review between March 2018 to June 2021 and semi-structured interviews with clients.
Results: A total of 104 files were reviewed (48 before versus 56 during COVID-19). Proportion of female and percentage of clients from culturally and linguistically diverse background seen between these 2 periods were similar; mean age of client seen pre-COVID-19 was significantly higher [83.5 years (SD 8.4) versus 80.1 years (SD 8.0); p=0.04]. More telehealth services were provided during COVID-19 (n= 36/53; 67.9%) compared to more face-to-face pre-pandemic (n=39/48; 81.3%). The telehealth service required significantly more carer involvement (n= 22/48; 45.8% pre-pandemic; n= 43/53; 81.1% during COVID-19). There was no difference in anthropometric, dietary, and nutritional outcomes for clients seen before versus during COVID-19 —both groups showed significant improvements. Although clients valued telehealth, they expressed a preference for the service to be face-to-face (n=3).
Discussion: Telehealth was a safe and effective service delivery mode. However, client preference coupled with the increased burden on carers suggests telehealth is not a panacea for these frail older clients. Future research is needed to explore the longer-term outcomes and client experience of both service delivery modes.
Biography
Vicky is a senior dietitian with over 20 years of experience working in NSW Health. She specializes in aged care nutrition and chronic disease management. Thanks to her strong interest in nutrition, Vicky has obtained the postgraduate degree in dietetics after completing her medical internship. She presented her research on “The effectiveness of dietetic interventions in improving the nutritional status of Commonwealth Home Support Program clients” at the Dietitians Association’s National Conference in 2018. Vicky is passionate in improving the nutritional status of older people in the community.