Study highlights the benefits of COVID-19 care at long-term acute care hospitals

Patients with severe COVID-19 and related complications can benefit from receiving postacute 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: Single-Center Retrospective Study," a study conducted by medical and therapy staff at Gaylord Specialty Healthcare, an LTACH in Wallingford, Connecticut, and researchers at the Milne Institute for Healthcare Innovation, were published today in the journal JMIR Rehabilitation and Assistive Technologies.

With an average patient length of stay of 25-28 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 and continued treatment for underlying conditions, and many offer targeted holistic rehabilitation therapies.

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. 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. [Stephen Holland, MD, FAPWCA, ABIM, MPA, chief medical officer at Gaylord Specialty Healthcare]

The single-center retrospective analysis evaluated the outcomes of 117 medically complex patients admitted to Gaylord Hospital between March 19 and August 14, 2020, for medical management of COVID-19 and intensive rehabilitation. These outcomes were compared to those of a reference population of 157 medically complex patients admitted to Gaylord Hospital 3 months prior, from December 2019 through February 2020.

Comparing the two populations, the authors observed that the sample of patients with COVID-19 was significantly younger, had similar proportions of male and female patients, and had an increased proportion of patients self-reporting as non-White. This sample of patients with COVID-19 was also found to have a similar length of hospital 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 significant functional improvement in the level of assistance required and distance walked at discharge.

Peter Grevelding, PT, MSPT, NCS, vice president of clinical operations at Gaylord Specialty Healthcare, executive director at Milne Institute for Healthcare Innovation, noted 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."