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Measuring Discharge Outcomes, Length of Stay, and Functional ADL Score During COVID-19 in Inpatient Rehabilitation Hospitals.
Hartsgrove, Caitlin; Guevarra-Fernandez, Jenieve; Kendall, Jamila; Delauter, Gabrielle; Kirshblum, Steven.
  • Hartsgrove C; From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ; Rutgers New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ. Electronic address: caitlinhartsgrove@gmail.com.
  • Guevarra-Fernandez J; Rutgers New Jersey Medical School, Newark, NJ.
  • Kendall J; From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ; Rutgers New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ.
  • Delauter G; Select Medical, Mechanicsburg, PA.
  • Kirshblum S; From the Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ; Rutgers New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ.
Arch Phys Med Rehabil ; 102(12): 2291-2299, 2021 12.
Article in English | MEDLINE | ID: covidwho-1321987
ABSTRACT

OBJECTIVE:

To measure discharge disposition, length of stay (LOS), and functional activities of daily living (ADL) scores for patients admitted to acute inpatient rehabilitation hospitals (IRHs) during the coronavirus disease 2019 (COVID-19) pandemic and to compare these parameters with a period prior to the pandemic.

DESIGN:

Retrospective cohort study via systematic retrospective chart review of consecutive patients admitted to IRHs from January 1-February 19, 2020 (pre-COVID-19T), and COVID-19 time period/patients admitted from April 1, 2020-May 9, 2020 (COVID-19T).

SETTING:

System of 3 IRHs in the Northeastern United States.

PARTICIPANTS:

Pre-COVID-19T, n=739; COVID-19T, n=335, of whom n=139 were positive for COVID-19 (COVID+) and n=196 were negative (COVID-) (N=1074).

INTERVENTIONS:

Not applicable. MAIN OUTCOME

MEASURES:

Discharge disposition, LOS, and functional ADL scores.

RESULTS:

COVID-19T patients were younger (P=.03) and less likely to be White (P=.03). These patients also had a higher case mix index (CMI; P<.01), longer acute care LOS (P<.01), and longer IRH LOS (P<.01). Patients who were COVID+ (during COVID-19T) were less likely to be White (P<.01), had lower CMI (P<.01), had higher admission and discharge functional ADL scores (P=.02, P<.01), and had longer acute care LOS compared with those who were COVID- (P<.01). There were no differences in discharge outcomes between pre-COVID-19T and COVID-19T cohorts (P=.75), including when stratified for COVID-19 status (P=.74). Functional ADL scores on admission and discharge were lower in COVID-19T than in pre-COVID-19T (P=.01), including when stratified for COVID-19 status though not significant (P=.06).

CONCLUSIONS:

There were no differences in discharge outcomes for any group. IRH LOS was significantly increased during the pandemic, but there were no statistically significant differences between the COVID+ and COVID- cohorts within COVID-19T. Functional ADL scores were significantly lower during COVID-19T, but COVID status was not a significant predictor. This suggests that COVID+ status was not a barrier to discharge or functional outcomes. This supports the importance of IRHs to restore function and discharge patients to home, even with a more medically complex COVID-19 pandemic population.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Discharge / Activities of Daily Living / Hospitals, Rehabilitation / COVID-19 / Length of Stay Type of study: Cohort study / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Arch Phys Med Rehabil Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Discharge / Activities of Daily Living / Hospitals, Rehabilitation / COVID-19 / Length of Stay Type of study: Cohort study / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Arch Phys Med Rehabil Year: 2021 Document Type: Article