Rehabilitation Characteristics in High-Performance Hospitals after Acute Stroke

The analysis of this is totally wrong. These are not high performance hospitals. The shorter length of stay means that these patients had less severe strokes. Patients that can engage in more therapy were less disabled to begin with.  Do we not have anyone with more than two functioning neurons in the stroke medical world? And the mentors and senior researchers didn't catch this bad research?
https://www.sciencedirect.com/science/article/pii/S1052305718302155

• Masashi Sawabe, RPT^*,
• Ryo Momosaki, MD, PhD, SPH^{†, ‡, ,} ,
• Kiyotaka Hasebe, RPT^*,
• Akira Sawaguchi, RPT^*,
• Seiji Kasuga, RPT^*,
• Daichi Asanuma, RPT^*,
• Shoya Suzuki, RPT^*,
• Narimi Miyauchi, RPT^*,

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https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.04.037

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Background

Rehabilitation characteristics in high-performance hospitals after acute stroke are not clarified. This retrospective observational study aimed to clarify the characteristics of high-performance hospitals in acute stroke rehabilitation.

Methods

Patients with stroke discharged from participating acute hospitals were extracted from the Japan Rehabilitation Database for the period 2006-2015. We found 6855 patients from 14 acute hospitals who were eligible for analysis in this study after applying exclusion criteria. We divided facilities into high-performance hospitals and low-performance hospitals using the median of the Functional Independent Measure efficiency for each hospital. We compared rehabilitation characteristics between high- and low-performance hospitals.

Results

High-performance hospitals had significantly shorter length of stay. More patients were discharged to home in the high-performance hospitals compared with low-performance hospitals. Patients in high-performance hospitals received greater amounts of physical, occupational, and speech therapy. Patients in high-performance hospitals engaged in more self-exercise, weekend exercise, and exercise in wards. There was more participation of board-certified physiatrists and social workers in high-performance hospitals.

Conclusions

Our data suggested that amount, timing, and type of rehabilitation, and participation of multidisciplinary staff are essential for high performance in acute stroke rehabilitation.

Key Words

• Activities of daily living;
• aged;
• stroke;
• quality indicator;
• pay for performance

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Grant support: This work was supported by a grant from the Japan Society for the Promotion of Science (grant number: 15K01395).

Address correspondence to Ryo Momosaki, MD, PhD, MPH, Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, 5-1-1 Futako, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.