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Implementation Rate of Physical Rehabilitation in Neonatal Intensive Care Units in Japan: A Retrospective
Yuto Ogata1, Ryutaro Matsugaki2, Manami Zaizen1
1Department of Rehabilitation, University Hospital of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8556, Japan.
Insights
Physical rehabilitation is provided to 18% of very-low-birth-weight infants (VLBWI) in neonatal intensive care units (NICUs). Extremely preterm and low-birth-weight infants are more likely to receive these crucial interventions.
Area of Science:
- Neonatal care
- Pediatric physical therapy
- Infant health
Background:
- Previous studies highlight the benefits of physical rehabilitation for very-low-birth-weight infants (VLBWI).
- The actual implementation rates of these interventions in neonatal intensive care units (NICUs) require further clarification.
Purpose of the Study:
- To determine the real-world implementation rate of physical rehabilitation among VLBWI admitted to NICUs.
- To identify factors associated with receiving physical rehabilitation in this vulnerable population.
Main Methods:
- An observational study utilizing real-world data from Japan's nationwide administrative database (2014-2019).
- Analysis of 30,464 infants admitted to NICUs, examining overall rehabilitation rates and participant characteristics.
Main Results:
- The overall physical rehabilitation rate in NICUs was 18%.
- Infants born at <28 weeks and extremely low birth weight infants (ELBWI) showed higher rates of physical rehabilitation.
- Patients receiving physical rehabilitation had longer NICU and hospital stays but also higher discharge rates.
Conclusions:
- Approximately one-fifth of NICU patients received physical rehabilitation interventions.
- Extremely preterm infants and ELBWI were more likely to benefit from these interventions.
- Strategies to increase physical rehabilitation rates in NICUs are necessary.
Abstract:
Background and Objective: The benefits of physical rehabilitation for very-low-birth-weight infants (VLBWI) have been reported in previous studies; however, the implementation rate of physical rehabilitation in this population remains to be clarified. This study aimed to examine the implementation rate of physical rehabilitation among VLBWI admitted to the neonatal intensive care unit (NICU) using real-world data. Material and Methods: This observational study obtained data from a nationwide administrative database associated with the diagnostic procedure combination (DPC) system in Japan (2014-2019). The participants were 30,464 infants admitted to the NICU between 2014 and 2019. The overall NICU physical rehabilitation rates and background factors of the participants were examined. Results: The overall physical rehabilitation rate in NICUs was 18%. Infants born at <28 weeks of age and extremely low birth weight infants (ELBWI) were more likely to receive physical rehabilitation interventions. The length of stay at the NICU and hospital, as well as the rate of discharge, were higher in patients who received physical rehabilitation than those in infants who did not. Conclusions: One-fifth of all patients admitted to the NICU received physical rehabilitation interventions. Extremely preterm infants and ELBWI were more likely to receive physical rehabilitation interventions. We need to consider ways to increase physical rehabilitation intervention rates in the NICU.
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