Oda Futoshi, Fukuda Haruhisa
Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital.
Graduate School of Medical Sciences, School of Medicine, Kyushu University.
Nihon Koshu Eisei Zasshi. 2021 Jan 30;68(1):3-11. doi: 10.11236/jph.20-063. Epub 2020 Oct 20.
Objectives The main purpose of rehabilitation is to improve the activities of daily living (ADL). Although convalescent wards are required to provide intensive rehabilitation to patients to improve their ADL, they have not been verified sufficiently. With a focus on the rehabilitation time, this study investigated the association of the amount of rehabilitation with ADL using a complete enumeration survey of a hospital bed function report system.Methods This retrospective cohort study focusing on convalescent wards nationwide was conducted using the panel data from hospital bed function reports between 2014 and 2017. We used a fixed effects regression analysis with the improvement rate of ADL as the outcome measure and the number of rehabilitation units as the exposure variable.Results The study sample included 2,003 wards, which were identified as having convalescent care functions from the report in 2014; a total of 437 wards (317 hospitals) were analyzed. The mean annual improvement rates of ADL were 0.601, 0.613, and 0.627 points in 2014, 2015, and 2017, respectively. The mean annual numbers of rehabilitation units provided were 6.302, 6.477, and 6.642 units in 2014, 2015, and 2017, respectively. The panel data analysis showed that the improvement rate of ADL was associated with an increase in the number of rehabilitation units (coefficient for an increase of one unit: 0.015, P=0.015).Conclusion In the study of ward units using a national-level survey, a longer rehabilitation time was significantly associated with improvements in ADL.
目的 康复的主要目的是改善日常生活活动能力(ADL)。尽管康复病房需要为患者提供强化康复以改善其ADL,但尚未得到充分验证。本研究以康复时间为重点,通过对医院病床功能报告系统进行全面枚举调查,探讨康复量与ADL之间的关联。
方法 本回顾性队列研究以全国范围内的康复病房为重点,使用了2014年至2017年医院病床功能报告中的面板数据。我们采用固定效应回归分析,以ADL改善率作为结局指标,康复单元数量作为暴露变量。
结果 研究样本包括2003个病房,这些病房在2014年的报告中被确定具有康复护理功能;共分析了437个病房(317家医院)。2014年、2015年和2017年ADL的年均改善率分别为0.601、0.613和0.627分。2014年、2015年和2017年提供的康复单元年均数量分别为6.302、6.477和6.642个。面板数据分析表明,ADL改善率与康复单元数量的增加相关(增加一个单元的系数:0.015,P = 0.015)。
结论 在使用国家级调查的病房单元研究中,较长的康复时间与ADL的改善显著相关。