A Survey of Medical Systems for Dysphagia Evaluation and Rehabilitation at Hospitals in Niigata Prefecture

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  • HARIGAI Toru
    Rehabilitation Center, Niigata University Medical and Dental Hospital
  • KIMURA Shinji
    Rehabilitation Center, Niigata University Medical and Dental Hospital
  • SANADA Nao
    Rehabilitation Center, Niigata University Medical and Dental Hospital
  • ENDO Naoto
    Rehabilitation Center, Niigata University Medical and Dental Hospital Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital
  • ITO Kayoko
    Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences
  • INOUE Makoto
    Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences

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Other Title
  • 新潟県内の病院における摂食嚥下障害の評価およびリハビリテーション診療体制調査
  • ニイガタ ケンナイ ノ ビョウイン ニ オケル セッショクエンカ ショウガイ ノ ヒョウカ オヨビ リハビリテーション シンリョウ タイセイ チョウサ

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Abstract

<p> Objective:　 This study surveyed the situation of evaluation of and rehabilitation for dysphagic patients at hospitals and the distribution of hospitals that can accept dysphagic patients in Niigata Prefecture and presents the problems involved in establishing a medical system for dysphagia.　 Methods:　 We conducted a questionnaire survey by mail of all hospitals in Niigata Prefecture from July 1, 2014 to August 30, 2014. The questionnaire contained items related to the following: presence or absence of evaluation of and rehabilitation for dysphagic patients; type of medical staff involved in evaluation and rehabilitation for dysphagic patients; examinations used in evaluating dysphagia; presence or absence and details of special foods for dysphagic patients; acceptance or non-acceptance of dysphagic inpatients and outpatients; and reasons for non-acceptance.　 Based on the responses, we made a distribution map of the hospitals which accepted dysphagic patients and performed detailed examinations (videofluoroscopic (VF) and/or videoendoscopic examination of swallowing (VE)).　 Results:　 Among the 130 hospitals, we received responses from 120 hospitals (92.3%). Evaluation of and rehabilitation for dysphagic patients were performed in 93 hospitals (77.5% of the 120 hospitals that answered the questionnaire) and 83 hospitals (69.2%), respectively. The medical staff involved in evaluation and rehabilitation included speech-language-hearing therapists (in 71 hospitals, 75.5% of the 94 hospitals that performed evaluation and/or rehabilitation), physicians (in 70 hospitals, 74.5%), and nurses (in 65 hospitals, 69.1%). VF and VE were performed in 41 hospitals (44.1% of the 93 hospitals that performed evaluation), and 29 hospitals (31.2%), respectively. Special foods for dysphagic patients were provided at 94 hospitals (78.3% of the 120 hospitals). Among the 120 hospitals, 47 hospitals (39.2%) and 60 hospitals (50.0%), respectively, accepted dysphagic outpatients and inpatients. The reasons for declining patients were lack of medical specialists and related staff, lack of experience or knowledge, and inadequate equipment. VF and/or VE was performed at 33 hospitals (27.5% of the 120 hospitals) that accepted outpatients and at 37 hospitals (30.8%) that received inpatients. Every secondary medical zone has hospitals which could accept dysphagic adult patients but two zones had no hospitals which could accept dysphagic children.　 Conclusions:　 Evaluation of and rehabilitation for dysphagic patients are conducted in over 70% of hospitals in Niigata Prefecture. Among those hospitals, about 30% can accept dysphagic patients from other medical institutions. We should support the two secondary medical zones in which there are no hospitals that can accept dysphagic children. </p>

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