RESEARCH REPORT PLATFORM PRESENTATION

COMPARING DISCHARGING POLICY FOR STROKE PATIENTS BETWEEN THE UK AND JAPAN. Kato G, Takahashi K, Akasaka K, Kurikawa M, Tokita K, Sawada Y; Department of Physical Therapy Saitama Medical School Junior Colloge Saitama Prefecture, Japan

PURPOSE: Nowadays, the importance of researching health policy has been increased because of its characteristic, “health service is scarce resource” which is influenced by social environment, such as aging society, economic situation, etc. Moreover, health staffs have gradually been involved in the health policy making process. It would be difficult to say that, as a member of medical staffs, physical therapists sufficiently participate in the policy making process because not many researches based on policy science have been achieved by physical therapists have been shown up in Japan. Therefore, this study aim to study about health policy, and facilitate puting more physical therapists into the policy process effectively. RELEVANCE: This study concerns the discharging policy for stroke patients for following reasons. First, stroke is world-widely known as a main cause of disability. Second, “bed-blocking”in the UK, and “socially being inpatient”, a situation that patient have to stay in the hospital because of their social reasons have been recognized as a social problem in both countries. Third, many physical therapists play a strong role in the process of discharging stroke patients. DESCRIPTION: To achieve understanding discharging policy for stroke patients, following procedure based on qualitative method was carried out. First, “Advocacy Coalition Framework”, one of policy science tools to demonstrate policy, was applied. Secondly, the data for the framework was collected through databases, Internet sites, and library catalogue. The key words were ‘stroke’, ‘discharge’, ‘comparative’, ‘policy’, ‘health’, ‘long term care’, ‘continuing care’, and ‘community care’. Finally, discharging policy for stroke patients was compared between the UK and Japan to help interpreting the policy with understanding what is same, and what is different between them. EVALUATION: This study achieved to illustrate two countries’ discharging policy for stroke patients. By reviewing 50 literature the framewark was completed. CONCLUSIONS: The comparison carried out in this study indicates some differences between them. First, the UK discharging policy intends to control discharging process with the responsibility set by law, in contrast Japanese one was controlled by the national insurance schedule. In concrete, if the stroke patients overstayed in the hospital with social reasons, and then the local government has to pay for the additional fee in the UK. In Japan, it is not possible that hospitals receive the normal payment for overstaying from the Japanese national insurance scheme but may accept reduction of medical expenditure due to reducing the national medical care cost. Secondly, the quantity of medical services, such as the opportunity to access to the hospital beds, computed tomography scans, Magnetic Resonance Imaging, is more frequently carried out in Japan. However, there is less quantity of social services in Japan. On the other hand, in the UK, more multiple professionals are involved in the discharging process for stroke patients. Particularly the quantity of social services, such as social works, is higher in the UK. IMPLICATIONS: Because of lack of medical services, ‘bed-blocking’ tends to be caused in the UK, however ‘socially being inpatient’ in Japan caused by the difficulties happened at the point when patients discharge from hospital. KEYWORDS: Health policy, Policy Science, Physical Therapist. FUNDING ACKNOWLEDGEMENTS: None. CONTACT: goheik@saitama-med.ac.jp