How oral intake, mobility, and activity measures can inform discharge recommendations: A retrospective analysis of hospitalized inmate and non-inmate COVID-19 patients. (Preprint)

Abstract

Patients who were incarcerated were disproportionately impacted by COVID-19 compared to the general public. Further, the impact of multidisciplinary rehabilitation assessments and interventions on the outcomes of patients admitted to the hospital with COVID-19 is limited.

To compare functional outcomes of oral intake, mobility, and activity between inmates and non-inmates who were diagnosed with COVID-19 and examine the relationships among these functional measures and discharge destination

A retrospective analysis was performed on patients admitted to the hospital for COVID-19 at a large academic medical center. Scores on functional measures including Functional Oral Intake Scale (FOIS) and Activity Measure for Post-Acute Care (AM-PAC) were collected and compared between inmates and non-inmates. Binary logistic regression models were used to evaluate the odds of 1) whether patients were discharged to the same place they were admitted and 2) patients being discharge with a total oral diet with no restrictions. Independent variables were considered significant if the 95% CIs of the odds ratios (ORs) did not include 1.0.

A total of 98 patients (inmates, n=48; non-inmates, n=50) were included in the final analysis. There were no differences between inmates and non-inmates on initial (P=.39) and final FOIS scores (P=.27) or on initial, final, or change scores (P>.05) on the AM-PAC. Greater age upon admission decreased the odds (OR=0.925; 95%CI=0.878 to 0.975 and OR=0.923; 95%CI=0.877 to 0.972) of patients being discharged with a total oral diet with no restrictions. The following factors increased the odds of patients being discharged to the same place there were admitted: being an inmate (OR=4.477; 95%CI= 1.110 to 18.062) and (OR=5.049; 95%CI=1.254 to 20.325); “Other” race (OR=9.807; 95%CI=1.283 to 74.943) and (OR=10.540; 95%CI=1.365 to 81.386)

Results from this study provide an opportunity to learn how functional measures may be used to better understand discharge outcomes in both inmate and non-inmate patients admitted to the hospital with COVID-19 during the initial period of the pandemic.

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