Shota Nagai, RPT, PhD, Shigeru Sonoda, MD, PhD, Ichiro Miyai, MD, PhD, Atsuo Kakehi,
Prof., Dr. Eng, Shinsuke Goto, RPT, Yuko Takayama, ST, Toshio Ota, MD, Isao Itoh, MD,
Shinichi Yamamoto, OTR, Yasuki Takizawa, MD, Katsuyuki Kaku, MSW, Yukiko Inoue, PhD,
Makoto Ishikawa, MD
Jpn J Compr Rehabil Sci 2: 77-81, 2011
Objective: To verify the scientific basis for gadditional
remuneration for providing rehabilitation services on
holidaysh and gadditional remuneration for enrichment
of rehabilitation programs,h 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.
Key words: kaifukuki rehabilitation ward, stroke, training time, rehabilitation outcome