Current Situation of Rehabilitation Treatment from the Perspective of Healthcare Costs in Japan

Objectives: Japan's rapidly aging population has led to an increased demand for rehabilitation services and rising medical expenses. However, the age-specific distribution of these services remains unclear. Methods: National Database open data from year (FY) 2019 to FY 2023 were used to analyze annual trends in rehabilitation fees by age, sex, and disease category. Results: The number of rehabilitation fee billing units decreased temporarily in FY2022, but increased in FY2023. Musculoskeletal rehabilitation also followed this trend. Cerebrovascular rehabilitation fees began to decline in FY2021, but increased again in FY2023. Disuse syndrome rehabilitation steadily increased, while pulmonary rehabilitation surged in FY2020. Cardiovascular rehabilitation decreased in FY2020, but increased again from FY2021. Most treatments peaked in patients in their 80s. Cardiovascular and cerebrovascular rehabilitation peaked in the early 80s, with a slightly higher incidence in men. Disuse syndrome rehabilitation peaked in the late 80s, and it was more common in women. Musculoskeletal rehabilitation had the highest unit count, peaking in the early 80s, with women accounting for twice as many cases as men. Respiratory rehabilitation peaked in late 80s, and it was more frequent in men. Cancer rehabilitation peaked in the late 70s, with men receiving treatment approximately twice as often as women. Conclusions: The number of rehabilitation fee units temporarily decreased in FY2022, but increased in FY2023. Cerebrovascular disease cases temporarily decreased, but increased again in FY2023. Overall, the number of units was the highest among patients in their early 80s. Cardiovascular disease, disuse syndrome, and respiratory rehabilitation showed an increasing trend among patients aged 80 years and older. Further increases are expected as the elderly population grows, and continuous monitoring is therefore necessary.