Patients with severe COVID-19 and related complications can benefit from receiving post-acute care at long-term acute care hospitals (LTACHs), a new report suggests. 

The findings of “Patient Outcomes and Lessons Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital: A Single-Center Retrospective Analysis,” a study conducted by medical and therapy staff at Gaylord Specialty Healthcare, an LTACH in Wallingford, Conn, and researchers at the Milne Institute for Healthcare Innovation, were published by the journal JMIR Rehabilitation and Assistive Technologies

With an average patient length of stay of 25 to 28 days, LTACHs are certified acute care hospitals equipped to provide long-term acute level care to medically complex patients. LTACHs provide an interdisciplinary care plan, continued treatment for underlying conditions, and many offer targeted holistic rehabilitation. 

“COVID-19 has resulted in significant morbidity for some patients who will need medical and rehabilitation care for six months or longer after the initial diagnosis,” says Stephen Holland, MD, FAPWCA, ABIM, MPA, chief medical officer, Gaylord Specialty Healthcare. “LTACHs not only can provide post-acute care and rehabilitation services in the post-COVID phase, but are also uniquely equipped to provide an alternative to conventional short-term acute care hospitals for patients with active COVID-19.”

The single-center retrospective analysis evaluated the outcomes of 117 medically complex patients admitted to Gaylord Hospital between March 19, 2020 and August 14, 2020 for medical management of COVID-19 and intensive rehabilitation. These outcomes were compared to a reference population of 157 medically complex patients admitted to Gaylord the three months prior, December 2019 through February 2020. 

Comparing the two populations, the authors observed that the COVID-19 population was significantly younger, had similar proportions of males and females, and had an increased proportion of patients self-reporting as non-white. The COVID-19 population was also found to have a similar patient length of stay compared to the reference population.

Using mechanical ventilation weaning rate, nutrition status, cognitive-communication status scores, functional independence measure assessments, and gait distance, the authors observed that the reference and COVID-19 populations recovered similarly when provided an LTACH level of interdisciplinary care, continued treatment for underlying conditions, and targeted holistic rehabilitation.

Interestingly, when compared to the reference cohort, the COVID-19 cohort showed a significant functional improvement in the level of assistance required and the distance walked at discharge compared to the reference cohort.

Peter Grevelding, PT, MSPT, NCS, vice president of clinical operations, Gaylord Specialty Healthcare, and executive director, Milne Institute for Healthcare Innovation, notes that the study supports shifting active COVID-19 care from short-term acute care hospitals (STACHs) to LTACHs to decrease STACH census and maximize limited resources during critical stages of the pandemic.

“We demonstrated the strategic use of LTACHs earlier in the hospital course to successfully treat and rehabilitate those with severe COVID-19 and alleviate crowded and overwhelmed short-term acute care hospitals,” he says. 

[Source: Gaylord Specialty Healthcare]