Summary of an article by David C. Grabowski and Karen E. Joynt Maddox, published in JAMA, recommending policies to support preparedness for COVID-19 in the postacute care sector. Postacute care settings include rehabilitation and palliative services to which people are discharged following a stay in hospital. The article’s recommendations include:
- All patients should be tested for COVID-19 when being discharged from hospital. Individuals with COVID-19 should only be discharged to facilities that have adequate isolating facilities.
- Identification of centres that can be rapidly upskilled and equipped to specialize on the care of patients recovering from COVID-19 (“centres of excellence”)
- Increasing capacity by, for example, retrofiting unused buildings
- Treating people in their own homes where possible, using hospital-at-home-models
- Staff need to be trained and equipped with personal protection equipment (PPE), and also tested regularly. Additional staff can be recruited to perform lower-skills tasks.
- Facilities need access to phsysicians, perhaps through telemedicine
- All postacute care staff should be provided with paid sick leave, to encourage staff who are sick to stay at home.
- Provision of financial incentives to facilities to accept COVID-19 cases, adn also reimbursement of hospital-at-home models at parity with institutional hospital care.
Link to the original article:
Citation of original article:
Grabowski DC, Joynt Maddox KE. Postacute Care Preparedness for COVID-19: Thinking Ahead. JAMA. Published online March 25, 2020. doi:10.1001/jama.2020.4686