A demand-capacity mismatch between rehabilitation need and service provision as a result of the COVID-19 pandemic? Early clinical observations from a large teaching hospital in London.
Vassilios Tahtis, Nicky Wilson, Frankie Northfield and 3 others
PMID 34563381WHAT IT FOUND
Therapists predicted far more patients needed bedded rehabilitation or institutional care than national discharge plans expected.
For COVID-19 patients, 23% were predicted to need these resources, compared to the 5% assumed in national guidance.
Key findings
01Predicted demand for bedded rehabilitation and institutional care exceeded national capacity estimates for both COVID-19 and non-COVID-19 patients.
02For COVID-19 patients, 10% were predicted to need bedded rehabilitation and 13% institutional care, versus national estimates of 4% and 1% respectively.
03Therapists could not predict discharge pathways for 28% of COVID-19 patients, citing clinical instability or sedation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study reports predicted discharge pathways based on therapist judgement, not actual destinations. This means the findings reflect what therapists thought patients would need, not what they actually received. Data were collected on a single day at one NHS Trust in London, so the results may not apply to other regions or times. The analysis did not adjust for patients' pre-admission residence or care needs, which could overestimate the new demand for rehabilitation services. Therapists ranged from junior to senior grades and were not directed by specific criteria, which may have introduced variability in how pathways were assigned.
Declared interests
None declared.
The easy way to misread this
Do not read these percentages as evidence of actual service demand. The study reports what therapists predicted on one day in one hospital, not what patients actually received. The authors state that interpretation should be cautious because actual discharge destinations were not measured.