[Pandemic COVID-19 impact in Rehabilitation Services in Spain]

Abstract

Introduction: The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients.

Material and methods: Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22^nd, 2020 to February the 12^th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS.

Objective: To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments.

Results: 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents.

Conclusions: The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.

Keywords: COVID-19; España; ICU; Rehabilitación; Rehabilitation; SARS-COV-19 pandemic; Spain; UCI.

Figura 1

Provincias donde se localizan los hospitales que participaron en la encuesta entre el 22-12-2020 y el 27-02-2021.

Figura 2

Dedicación media de cada profesional implicado en el proceso de rehabilitación (h/semana), enero-febrero 2020 (azul) y noviembre-diciembre del 2020 (rojo).

Figura 3

Hojas de consulta (HIC)/semana realizadas por médicos rehabilitadores en pacientes con COVID-19 en UCI, antes (enero-febrero del 2020) y durante la pandemia (noviembre- diciembre del 2020).