保険診療におけるリハビリテーション治療の実状

Real Situation of Rehabilitation Therapy from the Viewpoint of Medical Service Fees

要旨

目的：わが国は世界に先駆けて高齢者人口が増加している．それに伴い高齢患者も増加しており，リハビリテーション治療は重要である．リハビリテーション関連医療費も増加しているが，どのような年齢層にリハビリテーション治療が実施されているかについては知られていない．そこで今回，保険診療におけるリハビリテーション治療患者の年齢分布を調査したので報告する．

調査方法：厚生労働省が公表しているNDBオープンデータから，各疾患別リハビリテーション料の「性年齢別算定単位数」について2014（平成26）〜2019（平成31）年度の6年間の年次推移を検討した．

結果：心大血管疾患リハビリテーション料は80歳代前半にピークがあり，それまでは男性が約2倍多かった．脳血管疾患等リハビリテーション料は80歳代前半にピークがあり，男性のピークは70歳代後半でそれ以下の年代では男性のほうが多かった．廃用症候群リハビリテーション料は80歳代後半にピークがあり，女性のほうが多かった．運動器リハビリテーション料の算定単位数が最も多く，80歳代前半にピークがあり，女性は男性の2.5倍実施されていた．呼吸器リハビリテーション料は80歳代後半にピークがあり，男性のほうが多かった．がん患者リハビリテーション料は70歳代後半にピークがあり，男性が女性の約2倍であった．

結論：リハビリテーション治療実施患者の年齢のピークは80歳代であり，年々増加していた．

Abstract

Purpose：The older population in Japan is increasing faster than that in the rest of the world. As a result of the increasing number of elderly patients, rehabilitation treatment has become very important, resulting in rehabilitation-related medical expenses increasing, However, it is unclear which age groups are administered rehabilitation treatments. In this study, we investigated the age distribution of patients receiving rehabilitation treatment in Japan.

Methods：We investigated the age distribution of patients receiving rehabilitation treatment using insurance data.

Results：Rehabilitation fees for cardiovascular, cerebrovascular, and musculoskeletal diseases peaked in the early 80 years age group, whereas those of disuse syndrome, respiratory diseases, and cancer peaked in the late 80 years. Male patients with cardiovascular diseases were twice as common until 80 years of age. Regarding cerebrovascular diseases, the number of male patients peaked in the late 70s, and there were more male patients in the following age groups. More female patients in the late 80 years age group had disuse syndrome. Rehabilitation fees for musculoskeletal diseases had the highest number of units calculated, with 2.5 times as many female patients as male patients. As for respiratory diseases, more male patients were present in the late 80 years age group. Among patients with cancer, males were about twice as common as females.

Conclusion：The peak age of patients receiving rehabilitation treatment was in the 80 years age group, and the number of patients increased every year.