J Korean Phys Ther.  2022 Feb;34(1):26-37. 10.18857/jkpt.2022.34.1.26.

A Literature Review of Issues and Tasks by Period of Revision of Regulations Related to Convalescent Rehabilitation Wards in Japan: Focusing on Quality Evaluation

• Lee M
• Jeon B

• KMID: 2526917
• DOI: http://doi.org/10.18857/jkpt.2022.34.1.26

Abstract

Purpose
Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions.
Methods
Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000–2006); (2) quality evaluation introduction stage (2008–2014); and (3) quality evaluation maturity stage (2016– 2020).
Results
The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge.
Conclusion
It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

Keyword

Community care; Convalescent rehabilitation ward; Rehabilitation medical institute; Return to home; Quality evaluation