IMPACT OF THE COVID-19 PANDEMIC AND GOVERNMENTAL POLICIES ON REHABILITATION SERVICES AND PHYSICAL MEDICINE IN JORDAN: A RETROSPECTIVE STUDY

¹The University of Jordan, Physiotherapy, Amman, Jordan

Background: In line with the WHO initiative “Rehabilitation 2030: A Call for Action”, the Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme has published the Rehabilitation Research Framework for COVID-19 patients (CRRF). The CRRF offers a comprehensive view of the current evidence about the rehabilitation of patients with COVID-19 and highlights under-investigated areas where further studies are needed to inform best practices and ensure high-quality rehabilitation services. The CRRF revealed that most studies focus on the pandemic's micro-level and epidemiological aspects. Although the COVID-19 pandemic led to a series of governmental policies and regulations around the world, the effect of these policies on access to and provision of rehabilitation services has not been examined, especially in low and middle-income countries.

Purpose: The aims of this study were to examine (a) the impact of governmental policies and procedures on the number of patients who accessed rehabilitation services in the public sector in Jordan between January 2020 and February 2021, (b) the combined effect of sociodemographic factors (age and gender) and the governmental procedures on the number of patients who visited a rehabilitation center between January 2020 and February 2021, and (c) the most commonly provided rehabilitation services during the pandemic.

Methods: A retrospective cohort study was conducted based on records of 32,503 patients who visited the rehabilitation center between January 2020 and February 2021. Interrupted time-series analysis was conducted with three periods and by age and gender

Results: The number of patients who visited the rehabilitation clinics decreased significantly between January 2020 and May 2020 due to government-imposed policies, then increased significantly until peaking in September 2020 (p = 0.0002). Thereafter, the number of patients decreased between October 2020 and February 2021 as a result of the second wave of the COVID-19 pandemic (p = 0.02). The numbers of male and female patients did not differ (p >0.05). There were more patients aged 20 years and older attending rehabilitation clinics than younger patients during the first strict lock down and the following reduction of restriction procedures periods (p < 0.05).

Conclusions: The COVID-19 public measures in Jordan reduced access to rehabilitation services. New approaches to building resilience and access to rehabilitation during public health emergencies are needed. A further examination of strategies and new approaches to building resilience and increasing access to rehabilitation during public health emergencies is warranted.

Implications: The following recommendations are suggested to help Jordan's health systems implement resilient rehabilitation services: (1) incorporating acute care rehabilitation services into national health care plans as an essential component of quality care, (2) establishing policies to ensure continuity of rehabilitation during periods of limited access, such as policies regulating telerehabilitation, home programs, and in-home virtual reality services, (3) requiring rehabilitation professionals to attend continuing education courses that address the acute care competencies of the rehabilitation workforce, (4) providing services to people with disabilities through client-centered models, and (5) promoting public-private partnerships among healthcare sectors in order to meet the increased demand for rehabilitation services.

Funding acknowledgements: This work did not receive any funding.

Keywords:
COVID-19
Jordan
Rehabilitation

Topics:
COVID-19
Globalisation: health systems, policies & strategies
Disaster management

Did this work require ethics approval? No

Reason: The Institutional Review Board of the Jordanian Ministry of Health exempted the study from IRB approval because the records provided for the investigators were unidentifiable and patients’ identifying information was not shared.