PP380 - POLICY-DRIVEN IMPLEMENTATION OF GLIM CRITERIA AND VALIDATED NUTRITIONAL SCREENING TOOLS IN INPATIENT REHABILITATION: A NATIONWIDE SURVEY (2021–2025)

PP380

POLICY-DRIVEN IMPLEMENTATION OF GLIM CRITERIA AND VALIDATED NUTRITIONAL SCREENING TOOLS IN INPATIENT REHABILITATION: A NATIONWIDE SURVEY (2021–2025)

S. Nishioka^1,2,*, Y. Okamoto^2,3, Y. Kokura^2,4, T. Okamoto^5,6, I. Miyai^6,7

¹Graduate School of Regional Design and Creation, University of Nagsaki, Nishisonogi County, ²Nutrition Committee, Kaifukuki Rehabilitation Ward Association, Tokyo, ³Department of Clinical Nutrition and Food Services, Aijinkai Rehabilitation Hospital, Osaka, ⁴Department of Nutritional Management, Keiju Medical Center, Nanao, ⁵Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, ⁶Annual Survey Committee, Kaifukuki Rehabilitation Ward Association, Tokyo, ⁷Neurorehabilitation Research Institute, Morinomiya Hospital, Osaka, Japan

Rationale: In Japan, Convalescent (Kaifukuki) Rehabilitation Wards (KRWs) have been required or encouraged under the national health insurance system since 2024 to adopt the Global Leadership Initiative on Malnutrition (GLIM) criteria. This policy change is expected to promote use of GLIM criteria alongside validated nutritional screening tools.

Methods: We analyzed nationwide surveys conducted in 2021 and 2025 by the KRW Association, covering approximately 58% of all KRWs. Data on screening tools and diagnostic criteria for malnutrition implemented for each KRW were collected. Changes before and after the policy introduction were described and assessed using the Stuart–Maxwell test.

Results: A total of 879 hospitals (2021) and 913 hospitals (2025) were included. In 2021, composite indicators based on body weight, dietary intake, and/or hypoalbuminemia were most commonly used for screening (44%), followed by the Mini Nutritional Assessment–Short Form (MNA-SF) (10%). By 2025, MNA-SF was the most frequently used tool (54%), followed by the Malnutrition Universal Screening Tool (24%). For diagnosis, composite indicators predominated in 2021 (39%), while GLIM criteria were rarely used (2.4%). In 2025, GLIM criteria were implemented in 91% of KRWs. Adoption reached 100% in class 1 KRWs (GLIM-mandated) and 79% in class 2–5 KRWs (GLIM-recommended). Significant shifts toward validated tools and GLIM-based diagnosis were observed (both P<0.001).

Conclusion: Following policy changes, substantial adoption of validated screening tools and GLIM criteria was observed. These findings suggest that reimbursement policies can effectively promote standardized malnutrition screening and diagnosis, even without strict mandates.

Disclosure of Interest: S. Nishioka Grant / Research Support from: KAKENHI Grant-in-Aid for Scientific Research(C); Kaifukuki Rehabilitation Ward Association, Y. Okamoto: None declared, Y. Kokura: None declared, T. Okamoto: None declared, I. Miyai: None declared