AUTHORS

Francesco Bruggi¹, Francesco Falaschi², Antonio Di Sabatino^1,3, Paola Stefania Preti⁴, Carmine Tinelli⁵, Dominica Dell’Aera², Alessandra Martignoni², Stefano Perlini^1,6

TITLE

Correlation between attending physicians’ empathy and readmission rate in Internal Medicine.

RUNNING TITLE

Phisicians’ empathy and readmission rate

AFFILIATIONS

¹Facoltà di Medicina e Chirurgia, Università degli Studi di Pavia, Italia

²Medicina Generale 2, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia

³Medicina Generale 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia

⁴Dipartimento di Medicina Interna e Terapia Medica, Università degli Studi di Pavia, Italia

⁵Servizio di Epidemiologia Clinica e Biometria, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia

⁶Pronto Soccorso Accettazione, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia

ADDRESS FOR ALL AUTHORS

Segreteria Medicina Generale 2, Viale Camillo Golgi 19, 27100 Pavia, Italia

CORRESPONDING AUTHOR

Francesco Bruggi, f.bruggi@gmail.com; (+39) 333 103 7126

KEYWORDS

Empathy, readmission, heart failure, Internal Medicine.

ACKNOWLEDGEMENTS OF FUNDING OR OTHER SUPPORT

No fundings or other special grants were used to collect the data and to write the article .We wish to thank the Jefferson University (Philadelphia) in the person of Professor Vittorio Maio for kind concession of free use of Jefferson Scale of Empathy anf Funda Muge Topuz (Direzione Scientifica, Fondazione IRCCS Policlinico San Matteo) for the revision of the manuscript

DISCLOSURES

None for all authors

ABSTRACT

Introduction

Physician empathy has been correlated with several outcomes in outpatient settings, demonstrating better prognosis in patients followed by highly empathetic doctors.

Aim

To correlate empathy of Internal Medicine ward physicians with readmission rates of patients they took care of.

Methods

We extracted readmission data of all patients discharged from Internal Medicine wards at our hospital between January 1^st, 2011 and May 31^st, 2017. Patients discharged to other institutions (nursing homes, rehabilitation units, other hospitals) were excluded. The 30-day readmission rate was recorded for each doctor.

We measured the empathy of physicians who discharged more than 100 patients during that period, using the Jefferson Scale of Empathy (JSE) and the Empathy Components Questionnaire (ECQ).

Correlation between empathy scores and readmission rate was weighted for the number of patients followed by each physician and adjusted for sex, age and relative cost weight of patients, as well as the doctor’s age. The same correlation was calculated in the subgroup of index patients discharged with Diagnosis Related Group 127 (DRG 127, Heart Failure and Shock).

Results

A total of 4280 index discharge events were identified, 383 of which (8.9%) were readmitted within 30 days. JSE scores were found out to be inversely correlated with readmission rates (coefficient -0.027, R² 0.181, p<0.001) whereas ECQ correlation was not significant after adjustment. A significant inverse correlation was also observed considering only the DRG 127 patients, with both Empathy scales (JSE and ECQ, coefficient -0.032 and -0.098, R² 0.303 and 0.326, p=0.050 and p<0.001, respectively).

Conclusion

Empathy of Internal Medicine physicians correlates with readmission rates of the patients they cared for, especially heart failure patients for whom this is a relevant outcome.