CHANGES IN PATTERNS OF REFERRAL FOR INPATIENT REHABILITATION CANCER PATIENTS DUE TO COVID-19

ABSTRACT

Introduction There is a paucity of literature reflecting how the initial phases of COVID-19 and the changes to hospital processes affected referrals to cancer physiatry and inpatient cancer rehabilitation admissions. Methods A retrospective cross-sectional descriptive study was performed to evaluate inpatient hospital admissions, referrals to physiatry, and the number of patients admitted to inpatient rehabilitation and subsequent discharge disposition. There were no active interventions. Results In 2019 vs 2020, there were 10,274 vs 7,051 inpatient hospital admissions, 387 vs 337 referrals to physiatry, and 108 vs 102 rehabilitation admissions. There was an increase in referrals in 2020 (3.8% vs 4.8%, p=0.001) with no significant change to rehabilitation admissions (27.9% vs 30.3% p= 0.485). There was an increase in hematological services referrals and a decrease in neurosurgical services in 2020 (20.4% vs 31.4%;48.2% vs 26.5%;p = 0.01). There was an increased frequency of transfer back to primary acute care service in 2020 (7.4% vs 21.8%;p = 0.01). Conclusions During the COVID-19 pandemic, there was an increase in referrals to physiatry despite a decrease in hospital admissions, suggesting the importance of rehabilitation. There was an increase in the percentage of referrals by hematological services accompanied by a decrease in neurological services, likely due to decreased elective procedures. Finally, return to primary increased, which may be reflective of increased acuity of patients.