Changes in Patterns of Referral for Inpatient Rehabilitation Cancer Patients due to COVID-19: A Retrospective Study

Abstract

There is a paucity of literature on the effect of COVID-19 on hospital processes. We hypothesized that COVID-19 was associated with decreased cancer physiatry referrals in 2020. This is a retrospective cohort study of consecutive patients from April- July of 2019 and 2020 admitted at an academic quaternary cancer center. The main outcomes were number of hospital admissions, rate and characteristics of inpatient rehabilitation admissions and change in percentage of physiatry referrals as the primary endpoint. Results showed in 2019, there were 387 referrals from 10,274 inpatient admissions (3.8%; 95% CI: 2.4 - 4.2), compared to 337 referrals from 7,051 admissions in 2020 (4.8%; 95% CI: 4.3 - 5.3, p = 0.001). Hematology services referred more patients than neurosurgery in 2020 (20.4% vs 31.4%; 48.2% vs 26.5%; p = 0.01). Discharge disposition reflected an increased frequency of return to acute care service in 2020 (10.2% vs 21.8%; p = 0.03). In conclusion, there was an increase in the rate of physiatry referrals despite a decrease in hospital admissions. There was an increase in referrals by hematology, likely due to emphasis on safe discharge and the populations hospitalized.