OT services in different countries Occupational Therapist: JP Jan 2012 Occupational Therapy in Japan licensed occupational therapists 57,196 44,863 members of the Japanese Association of Occupational Therapists 7,250 176 NobuHiro NARA International University of Health and Welfare, JP occupational therapists graduating established OT schools (192 courses) 1
OT: Qualification and Licensure 1963 The first OT/PT school in Japan 1964 The law of Physical therapists and Occupational therapists 1966 The first national examination for PT/OT 20 new OT Japanese Occupational Therapists Association 1972 JOTA: the full member of WFOT 1981 Morethan1,000 OT 1998 More than 10,000 OT 2010 More than 50,000 OT 50000 40000 30000 20000 10000 0 Aging Society and OT 1970 1975 1980 1985 1990 1995 2000 2005 2010 <65 years old OT 2
Insurance system and OT Public Health Insurance system Since 1961 Long term care insurance system Since 2000 Acute phase 60% OT Chronic phase 20% OT 3
Medical Rehabilitation as medical services fee of health insurance system in JP Psychiatric OT(OT) Rehab for CVA (OT, PT, ST) Rehab for Orthopedic conditions(ot, PT) Rehab for Inveterate disease(ot, PT, ST) Respiratory Rehab(OT, PT, ST) Cardiac Rehab (PT) Group communication therapy (ST) Dysphagia Rehab (ST) Medical Rehab Service Fee for 1 Unit (20 minutes) 2010 1 point=10 JPY=1HKD 4
Rehab service from Acute to Chronic Phase Acute Sub-acute Acute Medical Rehabilitation Acute care/general Hospital 30(or 60)days since on-set Early Intervention/Prevention for disuse synd. Convalescent Rehabilitation Rehabilitation Focused Wards 180(or 240)days since on-set Intensive Rehab/Functional training/adl Long term care insurance system (2000) Implement society wide nursing care support for expanding old population. Reduce medical costs by social insurance system. Users can choose own services from a variety it of comprehensive healthcare and welfare services. Chronic Chronic Phase Rehabilitation Community based services/in home services Convalescent care unit/geriatric care Facility Super-aging society Prolonged hospital stay 5
Procedures for the use of service long term care insurance Assessment Reports Evaluation Conference Classification Long Term Care/Support Need Eligible services vary depending on the degree of long term care need Self support(not applicable for services) Preventive activities Support needed Level 1 & 2 Preventive care services Care needed From Level 1 to Level 5 Long term care services 6
Long term Care Services In home services Home helper, home visit nurse Day service, short stay service Rental services for equipment Services at facilities Nursing home Health care facilities Hospitals for long term care Takagi General Hospital (Ohkawa) Acute Phase Home visit nursing Home visit care Day care services Rehabilitation Services by IUHW/Kohoh kai G Yanagawa Rehabilitation Hospital (Yanagawa) Convalescent Rehabilitation Home Geriatric Health care Facility Out-patient rehabilitation Rehab for Chronic Phase Visiting rehabilitation services Technical aids/home renovation Rehabilitation i Specialists for Chronic Phase OT PT ST Total Community based 9 9 1 19 services In-home services 5 5 1 11 Facility services 5 3 1 11 Total 19 17 3 41 7
Community based Services Day (Care) Services Clients can use transportation services for servicecenters Services for Rehabilitation Functional exercise Daily Activity training Consultation about Technical Aids and Equipment In home Services Home visiting Rehabilitation Therapists visit clients home and provide services for 30 60 minutes Community Geriatric Rehabilitation Services & Occupational Therapy ADL 8
Community Geriatric Rehabilitation Services & Occupational Therapy Social Activity and Transportation Community Geriatric Rehabilitation Services & Occupational Therapy Function Physical/ cognitive 9
Community Geriatric Rehabilitation Services & Occupational Therapy Service coordination Community Geriatric Rehabilitation Services & Occupational Therapy Environmental Adaptation 10
Community Geriatric Rehabilitation Services & Occupational Therapy Education Family/Care person Environmental Adaptation ADL OT Roles Social Activity Using public transportation system Service coordination Education Family/Care person Function Physical/ cognitive 11
Society for all generations 12