Impact of rehabilitation-focused physician follow-up on activities of daily living 6 months after discharge from convalescent rehabilitation wards: a retrospective cohort study

Introduction Physician involvement after discharge from convalescent rehabilitation wards is inconsistent in Japan. While the value of board-certified physiatrists during inpatient rehabilitation is established, the impact of rehabilitation-focused physicians on long-term outcomes remains unclear. This study examined the association between regular postdischarge examinations by rehabilitation-focused physicians and activities of daily living (ADL) 6 months after discharge. Methods This retrospective cohort study analyzed data from a nationwide survey conducted by the Japan Association of Rehabilitation Hospital and Institution among 32 facilities, involving 183 patients discharged in August 2021. Patients were categorized according to whether they underwent regular postdischarge medical examinations by a rehabilitation-focused physician. The primary outcome was the Barthel Index (BI) at 6 months. Multiple linear regression analysis was performed with adjustment for age, sex, primary diagnosis, days from onset to discharge, care needs upon discharge, BI at discharge, and use of postdischarge rehabilitation services. Results The regular examination group included 89 (48.6%) patients. This group more frequently utilized outpatient, home-based, and day-care rehabilitation than the non-examination group (79.8% vs. 22.3%, p < 0.001) and had significantly higher BI scores at 6 months (median 90.0 vs. 75.0, p = 0.004). Regular medical examinations were independently associated with higher BI scores at 6 months ( B = 12.393, 95% CI: 5.171-19.615, p < 0.001). Discussion Regular postdischarge follow-up by rehabilitation-focused physicians was associated with better ADL outcomes 6 months after discharge. These findings underscore the potential importance of structured physician involvement within coordinated multidisciplinary transition pathways from inpatient to community-based rehabilitation. Further prospective studies are needed to confirm these findings and evaluate cost-effectiveness.