Impact of the COVID-19 pandemic on clinical outcomes of patients with a disability hospitalized on a medical service

Hilary Brown, University of Toronto Scarborough; Amol Verma, Temerty Faculty of Medicine; Fahad Razak, Temerty Faculty of Medicine; Yona Lunsky, Temerty Faculty of Medicine; Rahim Moineddin, Dalla Lana School of Public Health

The World Health Organization (WHO) estimates there are 1 billion people with a physical, sensory, or developmental disability globally. In North America, the prevalence of disability is 20%, with one-third of individuals over 65 years having a disability. While evidence suggests people with disabilities are at elevated risk for acquiring and suffering severe outcomes associated with COVID-19, the impact of the pandemic on hospital care and outcomes for patients with disabilities more generally has received little attention. Research in the general population shows communication failures contribute to patient harm, and pandemic conditions may have disproportionately hindered communication for patients with disabilities via restricted visitor policies and facemasks and face shields that impede communication. People with disabilities have also experienced disruptions to outpatient clinical, personal care, meal, and medication services that have had a profound impact on their well-being. These issues may contribute to elevated risk of adverse clinical outcomes in patients with disabilities on a medical service.

Our objective is to examine the impact of the COVID-19 pandemic on clinical outcomes (in-hospital mortality, intensive care unit [ICU] admission, hospital length of stay [LOS], unplanned 30-day readmission) of patients with and without a disability admitted to a medical service for non-COVID-related illnesses.

Our study has implications for pandemic resilience by providing data to support disability-related considerations in current (and future) pandemic responses, including training for health care providers on accessibility-related needs of hospitalized patients on a medical service, and development of supports for patients discharged from hospital who need additional assistance.