In-Clinic versus Hybrid Cancer Rehabilitation Service Delivery during the COVID-19 Pandemic: An Outcome Comparison Study

Abstract

Diminished health-related quality of life (HRQOL) is common among cancer survivors but often amendable to rehabilitation. However, few access real-world rehabilitation services. Hybrid delivery modes (using a combination of in-clinic and synchronous telehealth visits) became popular during the COVID-19 pandemic and offer a promising solution to improve access beyond the pandemic. However, it is unclear if hybrid delivery has the same impact on patient-reported outcomes and experiences as standard, in-clinic-only delivery. To fill this gap, we performed a retrospective, observational, comparative outcomes study of real-world electronic medical record (EMR) data collected by a national outpatient rehabilitation provider in 2020–2021. Of the cases meeting the inclusion criteria (N = 2611), 60 were seen to via hybrid delivery. The outcomes evaluated pre and post-rehabilitation included PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and the ability to participate in social roles and activities (SRA). The patient experience outcomes included the Net Promoter Survey (NPS®) and the Select Medical Patient-Reported Experience Measure (SM-PREM). A linear and logistic regression was used to examine the between-group differences in the PROMIS and SM-PREM scores while controlling for covariates. The hybrid and in-clinic-only cases improved similarly in all PROMIS outcomes (all p < 0.05). The association between the delivery mode and the likelihood of achieving the minimal important change in the PROMIS outcomes was non-significant (all p > 0.05). No between-group differences were observed in the NPS or SM-PREM scores (all p > 0.05). Although more research is needed, this real-world evidence suggests that hybrid rehabilitation care may be equally beneficial for and acceptable to cancer survivors and supports calls to expand access to and reimbursement for telerehabilitation.

Exploring the personal stroke and rehabilitation experiences of older adults with chronic stroke during the COVID-19 pandemic: a qualitative descriptive study

“…Given that virtual rehabilitation emerged during the pandemic, exploring experiences related to preference for community or home care in either a virtual or hybrid delivery format is warranted post-lockdown restrictions. In other countries, hospitals and rehabilitation facilities have continued using hybrid services for those living with chronic disease or other musculoskeletal injuries (Khatib & Hlayisi, 2022 ; Wood et al, 2023 ). Hybrid services have been seen as beneficial for patients and care providers thus far, although further research is warranted on this new topic (Khatib & Hlayisi, 2022 ; Wood et al, 2023 ).…”

“…In other countries, hospitals and rehabilitation facilities have continued using hybrid services for those living with chronic disease or other musculoskeletal injuries (Khatib & Hlayisi, 2022 ; Wood et al, 2023 ). Hybrid services have been seen as beneficial for patients and care providers thus far, although further research is warranted on this new topic (Khatib & Hlayisi, 2022 ; Wood et al, 2023 ).…”