抄録
Nagai S, Sonoda S, Miyai I, Kakehi A, Goto S, Takayama Y, Ota T, Itoh I, Yamamoto S, Takizawa Y, Kaku K, Inoue Y, Ishikawa M. Relationship between the intensity of stroke rehabilitation and outcome: A survey conducted by the Kaifukuki Rehabilitation Ward Association in Japan (second report). Jpn J Compr Rehabil Sci 2011: 77-81.
Objective: To verify the scientific basis for “additional remuneration for providing rehabilitation services on holidays” and “additional remuneration for enrichment of rehabilitation programs,” 2 new medical remuneration systems that were introduced in 2010.
Methods: Stroke patients admitted to kaifukuki rehabilitation wards were included in this study. Questionnaire forms were mailed to 11 member facilities of the Kaifukuki Rehabilitation Ward Association in Japan, and relevant data were collected. The 11 facilities were divided into 3 groups according to the total hours spent on physical, occupational, and speech-language-hearing therapy at each facility. Rehabilitation outcomes were compared between facilities that provided ≥6 units/day of rehabilitation 7 days per week for each patient (1 unit = a 20-minute rehabilitation) (≥6 units group), those providing ≥4 and <6 units/day of rehabilitation (4-6 units group), and those providing <4 units/day of rehabilitation (<4 units group).
Results: Total scores of the motor and cognitive items of the Functional Independence Measures on admission were significantly lower in the ≥6 units group than in the other 2 groups. The number of days spent in the rehabilitation facility was significantly lower, by approximately 12 days, in the ≥6 units group than in the other groups.
Conclusion: These results revealed that facilities providing ≥6 units/day of rehabilitation even on holidays enabled patients to be discharged from the facility in significantly fewer days, despite accepting patients with more severe stroke, compared to facilities providing fewer units of rehabilitation.
