A Network analysis of 2020/21 outpatient rehab data shows a dramatic drop in patient volume due to COVID-19.

The Network has been collecting and analyzing quarterly outpatient rehab data in the Toronto region for primary hip and knee replacement, stroke and hip fracture populations since 2014. The analysis allows Network members to compare their performance against best practice recommendations and other organizations.

This year, the Network focused on monitoring the impact of the pandemic on access to outpatient rehabilitation. Highlights from the 2020/21 year-end report include the following:

  • Referrals dropped dramatically: With the cancellation of surgeries due to COVID-19 and an initial decrease in stroke cases admitted through emergency departments, outpatient rehab volumes dropped as follows compared to 2019/20: hip fracture (-65%), total knee replacement (-39%), stroke (-30%) and total hip replacement (-29%).
  • Significant percentage of outpatient rehab was provided using virtual and hybrid models: The use of virtual and hybrid models of care varied by organization and patient group. Overall, 64% of patients who had a stroke received exclusively virtual or hybrid services, compared to 55% for hip fracture, 43% for total knee replacement and 20% for total hip replacement. Practices continue to evolve and will require continued evaluation of patient outcomes.
  • Number of attendances was lower than best practice recommendations: In the majority of outpatient rehab programs, the average number of attendances for total knee replacement, stroke and hip fracture was lower than best practice recommendations. It will be important to determine if this trend continues and whether patient outcomes are the same. For example, have efficiencies emerged with virtual/hybrid models that will require best practice recommendations to be updated?
  • Performance continues to improve on access benchmark for total knee replacements: The number of patients with total knee replacement admitted to outpatient rehab within seven days (the best practice recommendation) continues to rise. This upward trend began in 2017/18.

For more information, please contact Sharon Ocampo-Chan, Project Manager.