Response to the COVID-19 Pandemic Among Posthospital Brain Injury Rehabilitation Providers.
James F Malec, David B Salisbury, David Anders and 5 others
PMID 33253694WHAT IT FOUND
Seven posthospital brain injury rehabilitation organizations adapted services with telehealth and strict safety protocols during the pandemic.
Infection rates remained low among patients and staff, with zero deaths reported, though financial strain and service limitations were significant.
Key findings
01Telehealth became a primary method for delivering speech, occupational, and psychological therapies to reduce direct contact, though implementation took 2-3 weeks and faced barriers like technology access.
02Across 1820 persons served and 2027 staff, infection rates were low (1.1% of persons served, 2.1% of staff) and there were no deaths, with quarantine rates higher than infection rates.
03The financial impact of these adaptations was substantial, with telehealth reimbursement often inconsistent or below prior levels, threatening long-term organizational viability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a descriptive report of organizational responses, not a controlled trial, so it cannot determine the effectiveness of specific interventions compared to standard care. Data collection ended in May 2020, meaning the findings may not reflect later phases of the pandemic or the emergence of new variants. The report relies on self-reported data from seven organizations, which may not be generalizable to all posthospital rehabilitation settings. The lack of a comparison group means it is impossible to attribute the low infection rates solely to the described safety protocols rather than other factors. Financial and operational challenges are described qualitatively without standardized metrics for cost-effectiveness.
The easy way to misread this
Do not interpret the low infection rates as proof that these specific protocols are superior to others, as there was no control group and data was collected only through May 2020.