The respiratory rehabilitation Maugeri network service reconfiguration after 1 year of COVID-19

https://doi.org/10.4081/monaldi.2021.1843

Authors

  • Michele Vitacca | michele.vitacca@icsmaugeri.it Istituti Clinici Scientifici Maugeri, IRCCS Lumezzane, Italy. http://orcid.org/0000-0002-9389-7915
  • Piero Ceriana Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy.
  • Bruno Balbi Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy. https://orcid.org/0000-0002-4439-1424
  • Claudio Bruschi Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy. https://orcid.org/0000-0003-3840-2040
  • Maria Aliani Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy. https://orcid.org/0000-0001-8753-1303
  • Mauro Maniscalco Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy.
  • Francesco Fanfulla Department of Respiratory Rehabilitation ICS Maugeri IRCCS Pavia, Italy.
  • Aldo Diasparra Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy.
  • Luigino Rizzello Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy.
  • Daniela Sereni Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy.
  • Antonio Spanevello Department of Respiratory Rehabilitation, ICS Maugeri IRCCS, Pavia, Italy. https://orcid.org/0000-0002-3595-9903

Abstract

As part of the Italian Health Service the respiratory ICS Maugeri network were reconfigured and several in-hospital programs were suspended to be substituted by workforce and facilities reorganization for acute and post-acute COVID-19 care need. The present review shows the time course variation of respiratory ICS network in terms of admissions diagnosis and outcomes. A comparative review of the admissions and outcome measures data (anthropometric, admission diagnosis, provenience, comorbidities, disability, symptoms, effort tolerance, disease impact, length of stay and discharge destinations) over 1 year period (March 2020-March 2021) was undertaken and compared to retrospective data from a corresponding 1 year (March 2019-March 2020) period to determine the impact of the network relocation on the delivery of pulmonary specialist rehabilitation to patients with complex needs during the pandemic episode. One of the changes implemented at the respiratory Maugeri network was the relocation of the Pulmonary Rehabilitation units from its 351 beds base to a repurposed 247 beds and a reduction in total number of admitted patients (n=3912 in pre-COVID time; n=2089 in post COVID time). All respiratory diagnosis, except COVID sequelae, decreased (chronic respiratory failure-CRF, COPD, obstructive sleep apnoea syndrome-OSAS, interstitial lung disease-ILD, tracheostomized patients and other mixed diseases decreased of 734, 705, 157, 87, 79 and 326 units respectively). During the pandemic time, 265 post COVID sequelae with CRF were admitted for rehabilitation (12.62%), % of patients coming from acute hospital increased, LOS and NIV use remained stable while CPAP indication decreased. Disease impact, dyspnea and effort tolerance as their improvements after rehabilitation, were similar in the two periods.  Only baseline disability, expressed by Barthel index, seems higher in the 2° observation time as its improvement. Hospital deaths and transfers to acute hospitals were higher during pandemic crisis while home destination decreased. This review demonstrated impact of coronavirus pandemic situation, specifically the relocation of the respiratory inpatient rehabilitation wards in a huge Italian network.

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Published
2021-06-08
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Issue
Section
COVID-19 - Collection of articles on the Coronavirus outbreak
Keywords:
COVID-19, complex rehabilitation, hospital service reconfiguration, patient discharge, acute rehabilitation
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How to Cite
Vitacca, Michele, Piero Ceriana, Bruno Balbi, Claudio Bruschi, Maria Aliani, Mauro Maniscalco, Francesco Fanfulla, Aldo Diasparra, Luigino Rizzello, Daniela Sereni, and Antonio Spanevello. 2021. “The Respiratory Rehabilitation Maugeri Network Service Reconfiguration After 1 Year of COVID-19”. Monaldi Archives for Chest Disease, June. https://doi.org/10.4081/monaldi.2021.1843.

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