Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Sep 12;22(1):1148.
doi: 10.1186/s12913-022-08527-9.

Impact of low health literacy on patients' health outcomes: a multicenter cohort study

Rabia Shahid  1 , Muhammad Shoker  2 , Luan Manh Chu  3 , Ryan Frehlick  2 , Heather Ward  4 , Punam Pahwa  5
Affiliations
Multicenter Study

Impact of low health literacy on patients' health outcomes: a multicenter cohort study

Rabia Shahid et al. BMC Health Serv Res. .

Abstract

Background: This study aims to assess the health literacy of medical patients admitted to hospitals and examine its correlation with patients' emergency department visits, hospital readmissions, and durations of hospital stay.

Methods: This prospective cohort study recruited patients admitted to the general internal medicine units at the two urban tertiary care hospitals. Health literacy was measured using the full-length Test of Functional Health Literacy in Adults. Logistic regression analyses were performed to examine the correlation between health literacy and the desired outcomes. The primary outcome of interest of this study was to determine the correlation between health literacy and emergency department revisit within 90 days of discharge. The secondary outcomes of interest were to assess the correlation between health literacy and length of stay and hospital readmission within 90 days of discharge.

Results: We found that 50% had adequate health literacy, 32% had inadequate, and 18% of patients had marginal health literacy. Patients with inadequate health literacy were more likely to revisit the emergency department as compared to patients with adequate health literacy (odds ratio: 3.0; 95% Confidence Interval: 1.3-6.9, p = 0.01). In patients with inadequate health literacy, the mean predicted probability of emergency department revisits was 0.22 ± 0.11 if their education level was some high school or less and 0.57 ± 0.18 if they had completed college. No significant correlation was noted between health literacy and duration of hospital stay or readmission.

Conclusions: Only half of the patients admitted to the general internal medicine unit had adequate health literacy. Patients with low health literacy, but high education, had a higher probability of emergency department revisits.

Keywords: Emergency department revisit; Health literacy; Hospital readmission; Length of stay; Patient outcomes.

PubMed Disclaimer

Conflict of interest statement

None Declared.

Figures

Fig. 1
Fig. 1
Flow chart showing eligible patients
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun. 2010;15(Suppl 2):9–19. - PubMed
    1. Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67:2072–2078. - PubMed
    1. Nutbeam D, Muscat DM. Health promotion glossary 2021. Health Promot Int. 2021;36(6):1578–1598. - PubMed
    1. United States Department of Education National Center for Education Statistics. Adult literacy in the United States; July 2019. https://nces.ed.gov/data points/2019179.asp [Accessed 2 Jan 2022].
    1. Organization for Economic Cooperation and Development (OECD) OECD skills outlook 2013: first results from the survey of adult skills. Paris: OECD Publishing; 2013.

Publication types