the ministry of health , labour and welfare 
 of japan has recommended shortening of the length of hospital stays1 . in general , shortening the length of stay contributes to a 
 reduction in the physical and mental stress of patients and rapidly returns them to their 
 jobs and communities .
actually , in a previous study , it was shown that a shorter length of 
 stay resulted in not only a financial benefit but also a patient benefit2 .
the patient s benefit is spending less time 
 out of their home and reduction of the possibility of contracting nosocomial infections 
 during a stay in the hospital2 . in stroke 
 patients , stroke - related impairment , medical complications , family support , and
discharge 
 destination predict the length of stay3 . 
 in another previous study , impairment , activities of daily living ( adl ) , unplanned 
 discharges , and discharge to facilities affected the length of stay4 . on the other hand ,
similarly , patient - related factors were found to affect rehabilitation outcome , whereas 
 illness- and intervention - related factors did not6 .
this behavior pattern 
 includes impatience , urgency , aggressiveness , and particularity about details .
the type a 
 behavior pattern is regarded as an independent risk factor of cardiovascular diseases7 .
however , patients with type a behavior 
 pattern characteristics may have better compliance with rehabilitation and other forms of 
 medical and social support than those with non - type a behavior .
if patients with the type a 
 behavior pattern have better compliance , they would have a shorter length of hospital stay 
 than those with non - type a behavior . to examine this hypothesis , in this study , we compared 
 the length of stay of patients with the type a behavior pattern with that of patients with a 
 non - type a behavior pattern .
we hypothesized that length of stay of patients with the type a 
 behavior pattern would be shorter than that of patients with a non - type a behavior 
 pattern .
fifty - seven patients participated in this study . all patients had stayed in the 
 comprehensive rehabilitation unit of omaezaki municipal hospital between april and december 
 2013 .
the exclusion criteria were as follows : transfer to another hospital , medical 
 facility , or welfare facility during the research term and refusal to provide informed 
 consent .
type a behavior pattern was assessed by an abbreviated set of 12 questions developed by 
 maeda8 .
hardly  were scored as 2 , 1 , and 0 points , respectively , for nine 
 questions , and the points were doubled for three questions .
a total score of 17 or greater 
 was defined as type a , and the other subjects were defined as non - type a. after the subjects 
 were discharged , we counted the number of days between admission and discharge to evaluate 
 the length of stay . to evaluate the ability to perform adl at discharge , we measured barthel 
 index for all patients .
we used the student s t - test to examine statistical differences in 
 length of stay and barthel index at discharge between subjects with type a behavior and 
 those without type a behavior .
we analyzed these measurements by statistical package for social sciences ( spss ) 
 version 19 .
ultimately , 55 subjects ( 75.311.7  years old , 18 males and 37 females ) were classified into 
 either the type a group ( n = 26 ) or the non - type a group ( n = 29 ) , as shown in table 1table 1.characteristics of the type a and non - type a behavior patternscharacteristicstype a groupnon - type a grouppatients ( n)2629male ( n)108female ( n)1621cause of admissionstroke ( n)810fractures ( n)1310disuse syndrome ( n)23others ( n)36values represent number of subjects . others
causes of admission include spinal code 
 injury , spinal canal stenosis , and total knee arthroplasty .. the characteristics of subjects ( sex and cause of admission ) were similar in 
 the two groups .
age was not significantly different between the two groups . also , the 
 barthel index at discharge was not significantly different between the two groups .
however , 
 length of stay was significantly higher in the non - type a group compared with the type a 
 group ( p < 0.05 ) ( table 2table 2.difference in length of stay between the type a group and non - type a 
 groupscharacteristicstype a groupnon - type a groupage ( years)77.271.4discharge bi97.5897.08length of stay ( days)66.287.4 * * p < 0.05 vs. type a group , values represent averages .
others causes of admission include spinal code 
 injury , spinal canal stenosis , and total knee arthroplasty .
our results support the hypothesis that patients with the type a behavior pattern have 
 better compliance with forms of medical support than patients with a non - type a behavior 
 pattern .
patients with the type a behavior pattern had a shorter length of hospital stay 
 than patients with a non - type a behavior pattern . length of hospital stay can be affected by multiple factors , including medical 
 complication , family support , discharge destination3 , impairment , adl4 , 
 and rehabilitation9 .
patient - related 
 factors5 , especially psychological 
 factors6 , affect rehabilitation 
 outcomes .
the subjects in this study were patients who stayed in a comprehensive 
 rehabilitation unit .
patients who stay in a comprehensive rehabilitation unit do not require 
 much medical care and are able to focus on rehabilitation .
hence , our data suggest that 
 psychological factors of the patients , such as type a behavior , affect rehabilitation 
 compliance .
length of stay , ability to perform adl at discharge , and patient age influence 
 rehabilitation outcome and whether patients can return home or not10 , 11 .
there was no significant difference in 
 barthel index or patient age between patients with the type a behavior pattern and those 
 with a non - type a behavior pattern .
thus , it appears likely that ability to perform adl at 
 discharge , patient age , and destination at discharge do not influence length of stay .
the type a behavior pattern includes impatience , urgency , aggressiveness , and particularity 
 about details .
patients who have higher levels of physical activity during rehabilitation 
 were associated with a shorter length of stay12 . because patients with the type a behavior pattern might have good 
 compliance with rehabilitation and increase their physical activity
the type a behavior pattern is well known to be an independent 
 risk factor of cardiovascular diseases7 . 
 also in the japanese , the type a behavior pattern is associated with an increased risk of 
 acute myocardial infarction , especially in women13 .
so , the type a behavior pattern may be considered not a good 
 characteristics in general .
in contrast , another article reported that the type a behavior 
 pattern reduced the risk of coronary heart diseases in japanese men14 .
japanese men who do not express their anger may have an 
 increased risk of high blood pressure15 . 

this previous article indicates that non - type a japanese men may have a higher hypertension 
 risk than type a japanese men . in the japanese , the type
our results also show that patients with the type a 
 behavior pattern may be able to return home early .
finally , the cause of a short length of stay may not 
 be rehabilitation compliance .
in conclusion , our results suggest that the type a behavior pattern shortens the length of 
 hospital stay .
the data show that we should consider the patient s characteristics in 
 rehabilitation to protect the patient and for financial benefit .
 [ purpose ] the aim of this study was to describe the importance of patient - related factors 
 in rehabilitation . 
 we focused on the type a behavior pattern . 
 if individuals with the type 
 a behavior pattern have better compliance , they would have a shorter length of hospital 
 stay than those with non - type a behavior . 
 we compared the length of stay of patients with 
 the type a behavior pattern with that of patients with a non - type a behavior pattern . 
 
 [ subjects and methods ] fifty - seven patients staying in a comprehensive rehabilitation unit 
 participated in this study . 
 type a behavior pattern , length of stay , and barthel index 
 were assessed . 
 we use the student s t - test to examine the statistical differences in 
 length of stay and barthel index at discharge between subjects with type a behavior and 
 those without type a behavior . 
 [ results ] age and barthel index at discharge were not 
 significantly different between the two groups . however , length of stay was significantly 
 higher in the non - type a group compared with the type a group . 
 [ conclusion ] patients with 
 the type a behavior pattern had a shorter length of hospital stay than patients with a 
 non - type a behavior pattern . in conclusion 
 , our results suggest that the type a behavior 
 pattern shortens the length of hospital stay . 
 those data show that we should consider the 
 patient s characteristics in rehabilitation to protect the patient and for financial 
 benefit . 