Relationship between hospital ranking based on Functional Independence Measure (FIM) efficiency and factors related to rehabilitation system for stroke patients -A study of three hospitals participating in Kumamoto Stroke Liaison Critical Pathway-

Tokunaga M, Sannomiya K, Watanabe S, Nakanishi R, Yamanaga H, Yonemitsu H, Terasaki T, Mita S, Kawano S, Hirata Y, Yamaga M, Hashimoto Y, Sonoda S. Relationship between hospital ranking based on Functional Independence Measure (FIM) effi ciency and factors related to rehabilitation system for stroke patients -A study of three hospitals participating in Kumamoto Stroke Liaison Critical Pathway-. Jpn J Compr Rehabil Sci 2012; 3: 51-58. Purpose: The purpose of this study was to clarify the factors related to rehabilitation systems that yield high functional independence measure (FIM) effi ciency by conducting a questionnaire survey in the kaifukuki rehabilitation hospitals (KRHs) participating in the Kumamoto Stroke Liaison Critical Pathway. Methods: A total of 765 stroke patients were studied. FIM score gain and length of stay (LOS) at three hospitals in Kumamoto were classifi ed into two groups according to patients’ age and into three groups according to their FIM score at the time of admission. Then, FIM score gain and LOS were adjusted by the standard severity distribution value of the 765 patients to obtain the adjusted FIM effi ciency. The hospitals were ranked by the adjusted FIM effi ciency. In addition, we conducted a questionnaire survey on six factors related to the rehabilitation system and determined the factors that ranked the hospitals in the same order as that from ranking based on adjusted FIM effi ciency. Results: The adjusted FIM effi ciencies were 0.251 in Hospital A, 0.205 in Hospital B, and 0.225 in Hospital C. Among the six factors surveyed, the factors that gave the same hospital ranking as that based on adjusted FIM effi ciency were the number of rehabilitation and nursing staff members, and the number of patients hospitalized for stroke. Conclusion: Among the three hospitals in Kumamoto, the FIM effi ciency was high in the hospital with a large number of rehabilitation and nursing staff members and a large number of patients hospitalized for stroke.