An evaluation of the quality of post-stroke rehabilitation in Japan

Abstract

Context and objectives:

This study was to assess the differences in rehabilitation outcomes between the different facilities in Japan, and to determine if there was any variation in patients’ functional recovery at hospital discharge across the different facilities.

Methods:

This study focused on patients in recovery in the rehabilitation ward using the data of 680 patients from 12 hospitals after adjusting for triage at admission obtained from the Rehabilitation Patient Databank in Japan (issued in September, 2009) and compared the therapeutic results of each hospital. We estimate the expected value of levels of activities of daily living (ADL) at discharge for rehabilitation patients using regression analysis. Furthermore, we show the distribution of the expected improvement levels in ADL by hospitals.

Findings:

At the time of admission, there were no differences among hospitals in their patients’ characters. However, outcomes differed widely among the hospitals. The differences in the participation of physicians registered as rehabilitation specialists, conference execution rate, amount of exercise per day, self-exercise without a therapist, and exercise in wards, were statistically significant differences between hospitals.

Conclusion:

Due to the assessments for health care quality and the publication of results it is expected that health care providers will put in voluntary effort to improve their future health care services. Further studies should analyze the characteristics of high-performing hospitals.

Keywords::

• rehabilitation
• quality of care
• post-stroke