{
  "abstract": "Background Early mobilisation of intensive care unit (ICU) patients has been recommended in clinical practice guidelines. Therefore, the Japanese universal health insurance system introduced an additional fee for early mobilisation and/or rehabilitation, which can be claimed by hospitals when starting rehabilitation of ICU patients within 48 hours after their ICU admission. However, the effect of this fee is unknown.Objective To measure the proportion of ICU patients who received early rehabilitation and the impact on length of ICU stay, the length of hospital stay and discharged to home after the introduction of the financial incentive (additional fee for early mobilisation and/or rehabilitation).Design/methods We included patients who were admitted to ICU within 2 days of hospitalisation between April 2016 and January 2020. We conducted interrupted time series analyses to assess the effects of the introduction of the financial incentive.Results The proportion of patients who received early rehabilitation immediately increased after the introduction of the financial incentive (rate ratio (RR) 1.293, 95% CI 1.240 to 1.349). The RR for proportion of patients received early rehabilitation was 1.008 (95% CI 1.005 to 1.011) in the period after the introduction of the financial incentive compared with period before its introduction. There was no statistically significant change in the mean length of ICU stay, the mean length of hospital stay and the proportion of patients who were discharged to home.Conclusion After the introduction of the financial incentive, the proportion of ICU patients who received early rehabilitation increased. However, the effects of the financial incentive on the length of ICU stay, the length of hospital stay and the proportion of patients who were discharged to home were limited.",
  "authors": [
    {
      "affiliations": [
        "Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan"
      ],
      "name": "Yudai Honda"
    },
    {
      "affiliations": [
        "Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan"
      ],
      "name": "Jung-ho Shin"
    },
    {
      "affiliations": [
        "Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan"
      ],
      "name": "Susumu Kunisawa"
    },
    {
      "affiliations": [
        "Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan"
      ],
      "name": "Kiyohide Fushimi"
    },
    {
      "affiliations": [
        "Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan",
        "Department of Health Security System, Kyoto University Graduate School of Medicine, Centre for Health Security, Kyoto, Japan"
      ],
      "name": "Yuichi Imanaka"
    }
  ],
  "title": "Impact of a financial incentive on early rehabilitation and outcomes in ICU patients: a retrospective database study in Japan",
  "uid": "e33aba6b-9ad1-5bcd-8bea-a9ce765249d1"
}