A Health Insurance System for Maintaining or Improving Activities of Daily living in Acute Wards in Japan

Inpatients’ physical activity is commonly restricted because of treatment, leading to declines in Activities of Daily Living (ADLs) and prolonged hospital stay. In 2014, an additional health insurance system for maintaining or improving ADLs (“ADL ijikoujoto-taiseikasan” in Japanese) was newly established by the Japanese government. The fundamental policies for this system are as follows: (1) preventing functional declines of ADLs during hospitalization and facilitating early discharge and (2) enhancing multidisciplinary approaches and safety management, preventing disuse syndrome and pressure sores, and sharing information with patients and their families. To date, two studies have reported that immediate intervention by assigned physical and/or occupational therapists in acute wards under this health insurance system effectively prevents declines in ADLs and reduces hospital stay.