Nationwide survey conducted on exercise instruction for hemodialysis patients after changes to insurance system

Ryota Matsuzawa, lecturer in the Department of Department of Physical Therapy Rehabilitation, Hyogo Medical University College of Medicine (located in Nishinomiya, Hyogo Prefecture; President: Keiichiro Suzuki), and his colleagues conducted a joint research project with other institutions as part of a research working group within the Academic Committee of the Japanese Society of Renal Rehabilitation. They conducted a survey and reported on the current state of renal rehabilitation for hemodialysis patients in Japan.

This research was published in Scientific Reports (2022 JOURNAL IMPACT FACTOR: 4.6).

As of April 2022, Japan will allow additional medical treatment fees for exercise instruction during hemodialysis to be claimed in insurance claims.
The Japanese Society of Renal Rehabilitation conducted a questionnaire survey targeting dialysis facilities nationwide to investigate the current situation regarding exercise instruction during hemodialysis.

A survey regarding exercise instruction during hemodialysis was mailed to 4,257 dialysis facilities in Japan. Of the 1,657 facilities that responded, 550 (33%) provided exercise instruction, and 65% of these facilities claimed insurance coverage. Furthermore, of the 550 facilities that reported providing exercise instruction, 245 (55%) had begun providing exercise instruction after the April 2022 medical fee revision. Resistance training (81%) and aerobic exercise (62%) were the main types of exercise instruction, with the most common frequency being three times a week (80%). Doctors provided instruction in 45% of cases, followed by nurses in 74% and physical therapists in 36%. Furthermore, no serious adverse events were reported during exercise instruction. This study found that changes in the insurance system have promoted the widespread provision of exercise instruction during hemodialysis, leading to increased exercise participation among hemodialysis patients.

In the future, it will be necessary to evaluate what positive effects the promotion of exercise instruction and other measures due to changes in the insurance system has had on various patient outcomes.

Scientific Reports(2022 JOURNAL IMPACT FACTOR: 4.6)

Exercise instruction during haemodialysis treatment after changes to the insurance regime: a nationwide questionnaire survey in Japan

Masashi Sobue (※1), Ryota Matsuzawa (※2), Hiroki Nishiwaki (※3), Yohei Tsuchida (※4), Keio Ozaki (※5), Junichi Hoshino (※6), Kazue Narita (※7), Kunihiro Yamagata (※8)

*1 Department of Cardiovascular, Nephrology and Stroke Medicine, Kagawa University School of Medicine
*2 Department of Physical Therapy Faculty of Rehabilitation, Hyogo Medical University College of Medicine
*3 Showa University Fujigaoka Hospital, Department of Internal Medicine and Nephrology
*4 Shinrakuen Hospital, Department of Nephrology
*5 Faculty of Health and Sport Sciences, University of Tsukuba
*6 Department of Nephrology, Tokyo Women's Medical University
*7 Department of Nephrology and Rheumatology, Kidney Research Center, Graduate School of Medical and Dental Sciences, Niigata University
*8 Department of Nephrology, Faculty of Medicine, University of Tsukuba