title: Role of in-hospital care quality in reducing anxiety and readmissions of kidney transplant recipients.
abstract: A total of 17,000 patients receive kidney transplants each year in the United States. The 30-day readmission rate for kidney transplant recipients is over 30%. Our research focuses on the relationship between the quality of care delivered during the patient's hospital stay for a kidney transplant, and the patient health outcomes and readmissions related to the transplant.
  
  
  
  We interviewed 20 kidney transplant recipients at a major transplant center in the United States. Findings from these interviews were used to inform the data collection using structured surveys, which were administered to an additional 77 kidney transplant recipients. We used ordinary least squares regression to predict the effects of two dimensions of in-hospital care quality-information consistency and empathetic care delivery-on level of patient anxiety 1 week following discharge. Further, we estimated a logistic regression to predict the effect of anxiety, combined with the two dimensions of in-hospital care quality, on occurrence of 30-day readmissions.
  
  
  
  Patient anxiety levels 1 wk after discharge are significantly associated with information consistency and empathetic delivery of care. Patient anxiety 1 wk after discharge is associated with occurrence of 30-d readmissions. The logistic regression model indicates that the risk of getting readmitted is 110% higher for a one unit increase in patient anxiety level 1 wk after discharge. Finally, patient anxiety fully mediates the effects of consistency of information and empathetic care delivery on occurrence of 30-d readmissions (50.96% of the effect is mediated).
  
  
  
  Our study suggests two ways of preventing readmissions through reduction of postdischarge anxiety: (1) standardizing in-hospital care, so that information received by patients is consistent, and (2) by training caregivers to be more empathetic toward patients during the delivery of this information.
authors.affiliation: Management Sciences, Fisher College of Business, The Ohio State University, Columbus, OH.
authors.forename: Aravind
authors.initials: A
authors.lastname: Chandrasekaran
authors.affiliation: Business Administration College of Business, University of Illinois, Urbana Champaign, IL.
authors.forename: Gopesh
authors.initials: G
authors.lastname: Anand
authors.affiliation: Management Sciences, University of South Carolina, Columbia, South Carolina.
authors.forename: Luv
authors.initials: L
authors.lastname: Sharma
authors.affiliation: Department of Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH.
authors.forename: Todd
authors.initials: T
authors.lastname: Pesavanto
authors.affiliation: Department of Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Hauenstein
authors.affiliation: Department of Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH.
authors.forename: Michelle
authors.initials: M
authors.lastname: Nguyen
authors.affiliation: Management Sciences, Fisher College of Business, The Ohio State University, Columbus, OH.
authors.forename: Mrinalini
authors.initials: M
authors.lastname: Gadkari
authors.affiliation: Management Sciences, University of South Carolina, Columbia, South Carolina. Electronic address: susan.moffatt-bruce@osumc.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Moffatt-Bruce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Kidney transplant; Patient anxiety; Quality of care; Readmission; Survey