Japanese journal of comprehensive rehabilitation science · 2026
Association between activities of daily living and the introduction of home-visit medical care in patients with stroke discharged from a convalescent rehabilitation ward.
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Takaoka Tetsuya, Kasai Fumihito, Ikai Tetsuo
Аннотация
UNLABELLED: Takaoka T, Kasai F, Ikai T. Association between activities of daily living and the introduction of home-visit medical care in patients with stroke discharged from a convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2026; 17: 33-39.
OBJECTIVES: The Japanese government has implemented a community-based integrated care system, under which some patients with stroke receive home-visit medical care. This study aimed to determine the proportion of patients with stroke discharged from a convalescent rehabilitation ward who received home-visit medical care, and to identify the factors influencing its introduction.
METHODS: We analyzed 129 patients with stroke (cerebral infarction, n = 83; cerebral hemorrhage, n = 40; subarachnoid hemorrhage, n = 6) discharged from our convalescent rehabilitation ward in 2023. Patients were classified into a home-visit medical care group or an outpatient care group. Data collected included age, sex, hospitalization duration, functional independence measure (FIM) scores at admission and discharge, and the number of family members. Multivariate logistic regression analysis identified independent factors associated with the introduction of home-visit medical care.
RESULTS: The home-visit medical care introduction rate was 10.9%. Patients in this group were older and had longer hospital stays. Multivariate logistic regression analysis identified FIM motor scores (FIM-M) at discharge (odds ratio [OR] = 0.933, p = 0.027) and age (OR = 1.095, p = 0.011) as independent factors. Among patients with high FIM-M scores, those of older age and with lower FIM cognitive scores (FIM-C) were more likely to receive home-visit medical care.
CONCLUSIONS: Older patients with lower FIM-M scores at discharge were more likely to receive home-visit medical care. Additionally, even among those with a high FIM-M score, older age and lower FIM-C scores increased this likelihood. Early discharge planning that includes information on home-visit medical care may facilitate transitions to home care.
OBJECTIVES: The Japanese government has implemented a community-based integrated care system, under which some patients with stroke receive home-visit medical care. This study aimed to determine the proportion of patients with stroke discharged from a convalescent rehabilitation ward who received home-visit medical care, and to identify the factors influencing its introduction.
METHODS: We analyzed 129 patients with stroke (cerebral infarction, n = 83; cerebral hemorrhage, n = 40; subarachnoid hemorrhage, n = 6) discharged from our convalescent rehabilitation ward in 2023. Patients were classified into a home-visit medical care group or an outpatient care group. Data collected included age, sex, hospitalization duration, functional independence measure (FIM) scores at admission and discharge, and the number of family members. Multivariate logistic regression analysis identified independent factors associated with the introduction of home-visit medical care.
RESULTS: The home-visit medical care introduction rate was 10.9%. Patients in this group were older and had longer hospital stays. Multivariate logistic regression analysis identified FIM motor scores (FIM-M) at discharge (odds ratio [OR] = 0.933, p = 0.027) and age (OR = 1.095, p = 0.011) as independent factors. Among patients with high FIM-M scores, those of older age and with lower FIM cognitive scores (FIM-C) were more likely to receive home-visit medical care.
CONCLUSIONS: Older patients with lower FIM-M scores at discharge were more likely to receive home-visit medical care. Additionally, even among those with a high FIM-M score, older age and lower FIM-C scores increased this likelihood. Early discharge planning that includes information on home-visit medical care may facilitate transitions to home care.