Expansion of discharge planning system in Japan: Comparison of results of a nationwide survey between 2001 and 2010

Background: In response to the rapid aging of the population in Japan, many care systems have been created in quick succession. Establishment of discharge planning departments (DPDs) in hospitals is one of them. In this study, we compared the distribution and characteristics of DPDs and the characteristics of the hospitals that have DPDs between 2001 and 2010 in Japan. Methods: We mailed a questionnaire about the characteristics of hospitals and existence and situation of DPDs to all general hospitals with 100 or more general beds in 2001 and in 2010. Results: In 2001, of the 3,268 hospitals queried, 1,568 (48.0%) responded and 1,357 (41.5%) were selected for data analysis. In 2010, among 2,600 hospitals, 940 hospitals (36.1%) responded and 913 (35.1%) met the inclusion criteria. The percentage of hospitals with DPDs increased from 30% to more than 70% between the two surveys. More departments were under the direct control of the hospital director and more physicians participated in discharge planning activities in 2010 than in 2001. In 2001, private hospitals and hospitals with an affiliated institution or agency tended to have a DPD; however, the relationship between these factors and the presence of a DPD had disappeared in 2010. Larger hospitals and hospitals with more nurses per patient tended to have a DPD both in 2001 and 2010. Conclusions: Since 2008, the establishment of a DPD has been directly connected to medical fees so hospital administrators might have recognized the DPD as a 'necessary and paid for' department. Having a DPD was the majority's policy in Japan, and we must recognize the importance of quality assurance through DPDs from now on, especially in small hospitals.