Northwestern Feinberg School of Medicine, Chicago, Illinois, USA.
Shirley Ryan AbilityLab, Chicago, Illinois, USA.
PM R. 2024 Sep;16(9):966-972. doi: 10.1002/pmrj.13141. Epub 2024 Mar 23.
Neighborhoods with more social determinants of health (SDOH) risk factors have higher rates of infectivity, morbidity, and mortality from COVID-19. Patients with severe COVID-19 infection can have long-term functional deficits leading to lower quality of life (QoL) and independence measures. Research shows that these patients benefit greatly from inpatient rehabilitation facilities (IRF) admission, but there remains a lack of studies investigating long-term benefits of rehabilitation once patients are returned to their home environment.
To determine SDOH factors related to long-term independence and QoL of COVID-19 patients after IRF stay.
Multisite cross-sectional survey.
Two urban IRFs.
Primary outcome measures were Post-COVID Functional Status Scale (PCFS) and Short Form-36 (SF-36) scores. Secondary outcomes were quality indicator (QI) scores while at IRF and a health care access questionnaire. Results were analyzed using analysis of variance and multivariate logistic regression analyses.
Participants (n = 48) who were greater than 1 year post-IRF stay for severe COVID-19 were enrolled in the study. Higher SF-36 scores were associated with male gender (p = .002), higher income (≥$70,000, p = .004), and living in the city (p = .046). Similarly, patients who were of the male gender (p = .004) and had higher income (≥$70,000, p = .04) had a greater odds of a 0 or 1 on the PCFS. Age was not associated with differences. Women were more likely to seek follow-up care (p = .014). Those who sought follow-up care reported lower SF-36 overall and emotional wellness scores, p = .041 and p = .007, respectively. Commonly reported barriers to health care access were financial and time constraints.
Patients with SDOH risk factors need to be supported in the outpatient setting to maintain functional gains made during IRF stays. Female gender, income, and urban setting are potential predictors for long-term QoL and independence deficits after rehabilitation for COVID-19 infection. Low emotional wellness is an indicator for patients to seek out care as far out as 1 year from their rehabilitation stay.
具有更多健康社会决定因素（SDOH）风险因素的社区，其 COVID-19 的传染性、发病率和死亡率更高。患有严重 COVID-19 感染的患者可能会长期出现功能缺陷，导致生活质量（QoL）和独立性下降。研究表明，这些患者从住院康复设施（IRF）入院中受益匪浅，但仍缺乏研究调查患者返回家庭环境后康复的长期益处。
确定与 COVID-19 患者在 IRF 入住后长期独立和 QoL 相关的 SDOH 因素。
多地点横断面调查。
两家城市 IRF。
主要观察指标是 COVID-19 后功能状态量表（PCFS）和 36 项简短健康调查问卷（SF-36）评分。次要结果是在 IRF 时的质量指标（QI）评分和医疗保健获取问卷。使用方差分析和多变量逻辑回归分析对结果进行分析。
对因严重 COVID-19 而在 IRF 入住 1 年以上的参与者（n=48）进行了研究。较高的 SF-36 评分与男性（p=0.002）、较高的收入（≥$70,000，p=0.004）和居住在城市（p=0.046）有关。同样，男性（p=0.004）和高收入（≥$70,000，p=0.04）的患者在 PCFS 上的 0 或 1 的可能性更大。年龄与差异无关。女性更有可能寻求后续护理（p=0.014）。寻求后续护理的患者报告 SF-36 整体和情绪健康评分较低，p=0.041 和 p=0.007。常见的医疗保健获取障碍是经济和时间限制。
需要在门诊环境中为具有 SDOH 风险因素的患者提供支持，以维持在 IRF 入住期间获得的功能收益。女性、收入和城市环境是 COVID-19 感染康复后长期 QoL 和独立性缺陷的潜在预测因素。低情绪健康是患者在康复后 1 年寻求护理的一个指标。
