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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Functional outcomes and post-discharge care sought by patients with COVID-19 compared to matched controls after
Esha Jain1, Erin Y Harmon2, Matthew B Sonagere2
1Department of Medicine, Albany Medical Center, Albany, New York, USA.
Introduction:
A subset of patients with coronavirus disease 19 (COVID-19) can develop severe illness, resulting in significant functional and cognitive deficits that require acute inpatient rehabilitation. Guidelines following discharge from acute inpatient rehabilitation have not yet been established. This study seeks to establish outcomes of rehabilitation patients with COVID-19 and characterize their need for long-term care.
Objective:
To determine the functional outcomes and utilization of follow-up medical care for patients with COVID-19 90 days following discharge from acute inpatient rehabilitation, as compared to rehabilitation impairment and age-matched controls.
Design:
Prospective, single-center cohort study.
Setting:
Inpatient rehabilitation facility (IRF).
Patients:
Sixty-four patients recovering from COVID-19 and 64 age and impairment group category controls were identified to answer survey questions following discharge from inpatient rehabilitation. A total of 36 patients participated in the study (18 patients with COVID-19 and 18 controls).
Interventions:
Not applicable.
Main Outcome Measure(S):
Functional outcomes at discharge (GG Self-Care and Mobility Activities items of the IRF-PAI Version 3.0), hospital readmissions, and follow-up care sought by patients.
Results:
The COVID-19 patient group had similar improvements in functional outcomes as compared to controls. Patients with COVID-19 required fewer 0-90 day readmissions than their matched controls (22.2% vs 61.1%, P < .05), but there were no differences in 0-90 day urgent care/emergency department visits, clinic visits and use of outpatient therapies.
Conclusions:
Patients with functional deficits as a result of COVID-19 who require multiple therapy disciplines should be considered for acute inpatient rehabilitation as this study demonstrates their ability to participate in and benefit from IRF level care.
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