Sandro Iannaccone, Federica Alemanno, Elise Houdayer, Luigia Brugliera, Paola Castellazzi, Domenico Cianflone, Carlo Meloni, Alberto Ambrosio, Pietro Mortini, Alfio Spina, Massimo Filippi
Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
DOI: 10.2340/16501977-2704

Objective: The COVID-19 pandemic has caused significant motor, cognitive, psychological, neurological and cardiological disabilities in many infected patients. Functional rehabilitation of infectious COVID-19 patients has been implemented in the acute care wards and in appropriate, ad hoc, multidisciplinary COVID-19 rehabilitation units. However, because COVID-19 rehabilitation units are a clinical novelty, clinical and organizational benchmarks are not yet available. The aim of this study is to describe the organizational needs and operational costs of such a unit, by comparing its activity, organization, and costs with 2 other functional rehabilitation units, in San Raffaele Hospital, Milan, Italy.
Methods: The 2-month activity of the COVID-19 Rehabilitation Unit at San Raffaele Hospital, Milan, Italy, which was created in response to the emergency need for rehabilitation of COVID-19 patients, was compared with the previous year’s activity of the Cardiac Rehabilitation and Motor Rehabilitation Units of the same institute.
Results: The COVID-19 Rehabilitation Unit had the same number of care beds as the other units, but required twice the amount of staff and instrumental equipment, leading to a deficit in costs.
Discussion: The COVID-19 Rehabilitation Unit was twice as expensive as the 2 other units studied. World health systems are organizing to respond to the pandemic by expanding capacity in acute intensive care and sub-intensive care units. This study shows that COVID-19 rehabilitation units must be organized and equiped according to the clinical and rehabilitative needs of patients, following specific measures to prevent the spread of infection amongs patients and workers.

Many patients admitted to hospitals for Coronavirus Disease 2019 (COVID-19) can suffer from various disabilities, such as cardiorespiratory, motor, cognitive, psychological or neurological. These patients need to benefit from rehabilitation during their hospital stay, even when they are still presenting clinical signs of the infection. It is thus of high importance to set-up specialized rehabilitative units for COVID-19 patients. The San Raffaele Hospital of Milan (Italy) created a Unit for rehabilitation of infectious COVID-19 patients. Here, we described the organization needs and costs of such Unit and compared it with the organization and costs of two other rehabilitation Units, already previously in place in the hospital: the Cardiologic and the Motor Rehabilitation Units. We showed that the COVID-19 Rehabilitation Unit had as many care beds as the other units but required twice the amount of workers and equipment, leading to a cost twice superior to the other Units.