TY - JOUR
T1 - Variability in the Transition of Care to Poststroke Rehabilitation during the First Wave of COVID-19
AU - Venkatachalam, Aardhra M.
AU - Hossain, Sayeeda R.
AU - Manchi, Maunica R.
AU - Chavez, Audrie A.
AU - Abraham, Annie M.
AU - Stone, Suzanne
AU - Truong, Vincent
AU - Cobos, Carrie U.
AU - Khuong, Toan
AU - Atem, Folefac D.
AU - Welch, Babu G.
AU - Ifejika, Nneka L.
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Objective The aim of the study is to evaluate transitions of acute stroke and inpatient rehabilitation facility care during the first wave of COVID-19. Design This is a retrospective observational study (3 comprehensive stroke centers with hospital-based inpatient rehabilitation facilities) between January 1, 2019, and May 31, 2019 (acute stroke = 584, inpatient rehabilitation facility = 210) and January 1, 2020, and May 31, 2020 (acute stroke = 534, inpatient rehabilitation facility = 186). Acute stroke characteristics included stroke type, demographics, and medical comorbidities. The proportion of patients admitted for acute stroke and inpatient rehabilitation facility care was analyzed graphically and using t test assuming unequal variances. Results The proportion of intracerebral hemorrhage patients (28.5% vs. 20.5%, P = 0.035) and those with history of transient ischemic attack (29% vs. 23.9%; P = 0.049) increased during the COVID-19 first wave in 2020. Uninsured acute stroke admissions decreased (7.3% vs. 16.6%) while commercially insured increased (42.7% vs. 33.4%, P < 0.001). Acute stroke admissions decreased from 116.5 per month in 2019 to 98.8 per month in 2020 (P = 0.008) with no significant difference in inpatient rehabilitation facility admissions (39 per month in 2019, 34.5 per month in 2020; P = 0.66). In 2019, monthly changes in acute stroke admissions coincided with inpatient rehabilitation facility admissions. In 2020, acute stroke admissions decreased 80.6% from January to February, while inpatient rehabilitation facility admissions remained stable. Acute stroke admissions increased 12.8% in March 2020 and remained stable in April, while inpatient rehabilitation facility admissions decreased by 92%. Conclusions Acute stroke hospitalizations significantly decreased per month during the first wave of COVID-19, with a delayed effect on the transition from acute stroke to inpatient rehabilitation facility care.
AB - Objective The aim of the study is to evaluate transitions of acute stroke and inpatient rehabilitation facility care during the first wave of COVID-19. Design This is a retrospective observational study (3 comprehensive stroke centers with hospital-based inpatient rehabilitation facilities) between January 1, 2019, and May 31, 2019 (acute stroke = 584, inpatient rehabilitation facility = 210) and January 1, 2020, and May 31, 2020 (acute stroke = 534, inpatient rehabilitation facility = 186). Acute stroke characteristics included stroke type, demographics, and medical comorbidities. The proportion of patients admitted for acute stroke and inpatient rehabilitation facility care was analyzed graphically and using t test assuming unequal variances. Results The proportion of intracerebral hemorrhage patients (28.5% vs. 20.5%, P = 0.035) and those with history of transient ischemic attack (29% vs. 23.9%; P = 0.049) increased during the COVID-19 first wave in 2020. Uninsured acute stroke admissions decreased (7.3% vs. 16.6%) while commercially insured increased (42.7% vs. 33.4%, P < 0.001). Acute stroke admissions decreased from 116.5 per month in 2019 to 98.8 per month in 2020 (P = 0.008) with no significant difference in inpatient rehabilitation facility admissions (39 per month in 2019, 34.5 per month in 2020; P = 0.66). In 2019, monthly changes in acute stroke admissions coincided with inpatient rehabilitation facility admissions. In 2020, acute stroke admissions decreased 80.6% from January to February, while inpatient rehabilitation facility admissions remained stable. Acute stroke admissions increased 12.8% in March 2020 and remained stable in April, while inpatient rehabilitation facility admissions decreased by 92%. Conclusions Acute stroke hospitalizations significantly decreased per month during the first wave of COVID-19, with a delayed effect on the transition from acute stroke to inpatient rehabilitation facility care.
KW - Acute Stroke
KW - COVID-19
KW - Inpatient Rehabilitation Facility
KW - Transitions of Care
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U2 - 10.1097/PHM.0000000000002287
DO - 10.1097/PHM.0000000000002287
M3 - Article
C2 - 37205606
AN - SCOPUS:85178236912
SN - 0894-9115
VL - 102
SP - 1085
EP - 1090
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
IS - 12
ER -