• Health Policy and Management
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• v.31 no.4
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• pp.451-461
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• 2021

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

• Health Policy and Management
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• v.33 no.1
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• pp.40-54
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• 2023

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, 'rho' values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion: The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.26-37
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• 2022

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.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.103-114
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• 2023

PURPOSE: This study compared the effects of computer-based and virtual reality-based cognitive rehabilitation programs on the cognitive function, upper limb function, activities of daily living, and their impact on the prefrontal cortex in convalescent stroke patients. METHODS: Ten recovering stroke patients were assessed for their cognitive function, upper limb function, and daily living activities using the Neurobehavioral Cognitive Status Examination, the Korean version of the Fugl-Meyer Assessment, and the Korean version of the Modified Barthel Index. The prefrontal cortex activity was measured with functional Near Infrared Spectroscopy. The virtual reality-based cognitive rehabilitation group utilized a program of daily living activities delivered via a laptop and Oculus Rift. The computer-based cognitive rehabilitation group performed various cognitive tasks on an all-in-one PC. Both groups underwent cognitive rehabilitation training for 30 minutes per day, three times a week, for six weeks, with identical conventional rehabilitation therapies in the hospital. RESULTS: Both programs positively impacted the cognitive and physical functions. On the other hand, the virtual reality-based cognitive rehabilitation program had a larger influence on improving the cognitive and physical functions of convalescing stroke patients. CONCLUSION: The virtual reality program suggests its potential to enhance cognitive and physical functions in convalescent stroke patients through increased engagement, focus, real-time feedback, and game elements, making it a promising rehabilitation approach.

• The Journal of Korean society of community based occupational therapy
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• v.4 no.1
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• pp.1-10
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• 2014

Objective : The purpose of this study was to comparatively analyze time use and quality of life in stroke patients who use Local community or convalescent Hospital environment. Methods : The study subjects were 74 stroke patients who were admitted to convalescent Hospital or who were being rehabilitated as outpatients. The Occupational Questionnaire(OQ)was used for measuring time use and the Stroke Specific Quality of Life(SS-QOL) utilized to measure Quality of life. Excluding 8 patients who did not fit selection criteria, 66 patients were selected and analyzed. Results : After comparatively analyzing time use in Local community and convalescent Hospital environment, significant differences were found in daily living(p<.05), resting(p<.05). In addition, in quality of life, significant differences were found in family(p<.05), self-management(p<.05), and social roles(p<.05). Conclusion : Local community patients used their time in daily living, resting more efficiently than convalescent Hospital patients, and also had a higher quality of life.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.1
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• pp.61-72
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• 2012

Background: The purpose of this study was to analyze the associations between physical therapists' work-related musculoskeletal pain, quality of life (QoL), and presenteeism. Methods: Self-reported questionnaires were given to 402 physical therapists in Korea. Variables examined included the prevalence of pain sites related to work, pain intensity, pain pattern, pain frequency, pain duration, pain rating score (PRS), general characteristics, QoL, and presenteeism. Results: Of the 314 physical therapists who responded, 251 (79.9%) reported work -related musculoskeletal pain in at least one body part. The most affected regions included the wrist and hand (21.0%), shoulder (19.6%), and lower back (19.1%). On average patients, QoL and presenteeism differed significantly between physical therapists who reported pain and those who did not (P < 0.05). QoL showed a negative correlation with the work-related musculoskeletal pain (P < 0.01) and presenteeism (P < 0.01), while the presenteeism and work-related musculoskeletal pain showed positive one(P < 0.01). Factors influencing a physical therapist's QoL included presenteeism, Working venues (Convalescent hospital), Work status (Contra ct worker) and professional experience, while the presenteeism included QoL, work status (Intern), PRS, working venues (Convalescent hospital), Area of specialty (Pediatrics), age, sex and working hour. Conclusions: Results show that physical therapists appear to be at a higher risk for work-related musculoskeletal pain. Therefore, administrators need to use the intervention strategies to manage the presenteeism and QoL of physical therapists.

• Journal of The Korea Institute of Healthcare Architecture
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• v.14 no.2
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• pp.3-14
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• 2008

The rehabilitation for the workplace accident victims is basically aimed to get them back to their working place through the secondary care processes which have some more special and more professional rehabilitation than any others, after the primary treatments like operation in an acute hospital since the accident. They need more concentrative rehabilitation efforts according to classified injury types during the period of acute, sub-acute and convalescent. This study is for the partial research of rehabilitation hospital for workers' accident victims and presents design data which can be used for the appropriate area calculation and spatial composition. Drawing documents analysis, interviews, observation were used to examine the condition of existing rehabilitation hospitals.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.187-198
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• 2020

Purpose : This study was conducted to provide basic data for the association's policy management and to improve the activity areas by investigating Gyeonggi-do physical therapists' recognition of the national responsibility for dementia. Methods : A total of 1,839 physical therapists participated in this survey, and the data from a total of 29 questionnaires were analyzed using SPSS 22.0 windows. Results : Among the physical therapists in Gyeonggi-do, 61.1 % had low awareness of the national responsibility for dementia, and the recognition of the center for dementia was also low. On the other hand, there was a remarkably high opinion that the physical therapist was a necessary workforce, and positive responses to dementia-related work and education participation were also high, 51.9 % and 68.5 %, respectively. Those with a high educational background, annual salary, clinical experience, or dementia-related institutions, such as nursing homes and physical therapy, had a high awareness of "dementia national responsibility", awareness of "center for dementia" and "participation in dementia-related work and education". On the other hand, "work participation" and "education participation" were found to be inversely related to age and clinical experience. Conclusion : Physical therapists based in Gyeonggi-do showed an awareness of dementia policy. This result will help the association's policy management and protect the physical therapist's rights and interests.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.69-75
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• 2021

Objective: This study was aimed at investigating the effects of lumbar stabilization exercise according to correct verbal instructions in pain and muscle strengthening of the low back pain patients. Design: A randomized controlled trial. Methods: Twenty subjects with low back pain were selected. They were randomly assigned to one of two groups (10 in each group): namely the lumbar stabilization exercise and lumbar stabilization exercise according to the correct verbal instructions group. The lumbar stabilization exercise group performed lumbar stabilization exercises for 6 weeks (5 times a week). The lumbar stabilization exercise according to correct verbal instructions group performed lumbar stabilization exercise according to correct verbal instructions for 6 weeks (5 times a week). We measured pain, muscle power, proprioception, and body balance before and after exercise by using visual analog scale (VAS), digital handheld dynanometer, Joint repositioning error, time up and go test respectively. Results: We found statistically significant differences in pain, muscle power, proprioception, and body balance in lumbar stabilization exercise and lumbar stabilization exercise according to correct verbal instructions group, before and after (p<0.05). Conclusions: We confirmed the effect of lumbar stabilization exercise according to correct verbal instructions. Thus we thought these results could be used as basic data and reference for low back pain. But we need more study effect of correct verbal instructions on other exercises.

• Physical Therapy Rehabilitation Science
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• v.8 no.2
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• pp.86-92
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• 2019

Objective: The purpose of this study was to compare the effects of performing squats and kneeling squats on trunk and lower extremity muscle activity in persons with stroke. Design: Cross-sectional study. Methods: Ten persons with stroke (3 male and 7 female) were recruited. The subjects were instructed to randomly perform the 4 different squat conditions: squat with 30 degrees of knee flexion, squat with 60 degrees of knee flexion, squat with 90 degree of knee flexion, and the kneeling squat. During the squat performance, surface electromyograms (sEMG) was used to assess muscle activity of the erector spinae (ES), gluteus maximus (Gmax), gluteus medius (Gmed), and biceps femoris (BF) muscles. Results: Muscle activation of the ES and BF were significantly increased with the kneeling squats compared to the general squats with 30 degrees and 60 degrees of knee flexion (p<0.05), and muscle activation of the Gmax and Gmed were significantly increased with the kneeling squats compared to all other squat conditions (p<0.05). Conclusions: The results suggest that the kneeling squat is an effective exercise to strengthen the proximal muscles of the lower extremities. Rather than applying a difficult general squat to the stroke population, the kneeling squat may be applied as a safer method for training the proximal muscles.