Impact of COVID-19 on General Medical Rehabilitation Efficiency in Designated Inpatient Facilities: A Comparative Analysis of Patient Outcomes and Care Processes.

The study relied on medical records, which limited the scope of data to total FIM scores rather than specific motor or cognitive subscales. There was a high rate of missing data for FIM discharge assessments in the groups that acquired or had COVID-19 on admission, which required listwise deletion and reduced the sample size for the efficiency model. Age and medical diagnoses were not controlled for in the initial comparison, although they were included in the final model. The findings are based on a single health care system (Québec), so results may not apply to regions where length of stay is influenced by insurance or different institutional policies. The study could not separate the effect of any single component of care, such as isolation protocols versus resource reallocation, on the observed outcomes.

The authors declared no conflicts of interest. The study was approved by the Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain.

Do not conclude that COVID-19 infection itself directly causes long-term functional impairment. The study shows that the *process* of care was disrupted for those who acquired the infection in the facility, leading to slower daily gains and longer stays, but final discharge scores were similar to other groups. The negative association between professional involvement and efficiency reflects case complexity, not that more therapy is harmful.