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Health Literacy and Outcomes

By May 3, 2011Commentary

Health literacy relates to an individual’s ability to obtain and understand information needed to make health decisions.  It is believed to have an impact on both health care costs and quality, since a person who has adequate health literacy will presumably make better decisions, keeping themselves in better health and choosing more appropriate treatment options.  Research in the Journal of the American Medical Association used a survey of about 1500 HMO members to see if health literacy affected outcomes for heart failure patients.   (JAMA Article)

Literacy was assessed by a simple, easy to use three question survey that basically seeks to identify if the person feels they understand health forms and information given to them.  While we all might think health literacy is identical to education level or intelligence, apparently research has indicated that it is a separate variable.  The outcomes of interest in this study were all-cause mortality and all-cause hospitalization.  A number of variables other than health literacy were included in the analysis.

About 18% of patients had low health literacy, and as expected, they tended to be in a lower socioeconomic group, have more comorbidities and less likely to have at least a high school education.  Patients with a lower health literacy were found to have a higher risk of dying, but no greater risk of hospitalization.  Interestingly, low health literacy patients living in a nursing home or hospice were less likely to be hospitalized than those living independently, which suggests that the likely presence of a surrogate decision maker can ameliorate health literacy issues.  Based on this study, it is worth understanding the health literacy of a patient as an independent factor that may affect their health and health outcomes, and designing separate interventions for patients with low health literacy.

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