BACKGROUND: More than 25% of Medicare patients hospitalized for heart failure are readmitted within 30 days. The contributions of numeracy and health literacy to recidivism for patients with acute heart failure (AHF) are not known. METHODS AND RESULTS: A cohort of patients with acute heart failure who presented to 4 emergency departments between January 2008 and September 2011. Research assistants administered subjective measures of numeracy and health literacy; 30-day follow-up was performed by phone interview. Recidivism was defined as any unplanned return to the emergency department or hospital within 30 days of the index emergency department visit for AHF. Multivariable logistic regression adjusting for patient age, sex, race, insurance status, hospital site, days eligible for recidivism, chronic kidney disease, abnormal hemoglobin, and low ejection fraction evaluated the relation between numeracy and health literacy with 30-day recidivism. Of the 709 patients included in the analysis, 390 (55%) had low numeracy skills and 258 (37%) had low literacy skills. Low numeracy was associated with increased odds of recidivism within 30 days (adjusted odds ratio, 1.41; 95% confidence interval, 1.00-1.98; P=0.048). For low health literacy, adjusted odds ratio of recidivism was 1.17 (95% confidence interval, 0.83-1.65; P=0.37). CONCLUSIONS: Low numeracy was associated with greater odds of 30-day recidivism. Further investigation is warranted to determine whether addressing numeracy and health literacy may reduce 30-day recidivism for patients with acute heart failure.
BACKGROUND: More than 25% of Medicare patients hospitalized for heart failure are readmitted within 30 days. The contributions of numeracy and health literacy to recidivism for patients with acute heart failure (AHF) are not known. METHODS AND RESULTS: A cohort of patients with acute heart failure who presented to 4 emergency departments between January 2008 and September 2011. Research assistants administered subjective measures of numeracy and health literacy; 30-day follow-up was performed by phone interview. Recidivism was defined as any unplanned return to the emergency department or hospital within 30 days of the index emergency department visit for AHF. Multivariable logistic regression adjusting for patient age, sex, race, insurance status, hospital site, days eligible for recidivism, chronic kidney disease, abnormal hemoglobin, and low ejection fraction evaluated the relation between numeracy and health literacy with 30-day recidivism. Of the 709 patients included in the analysis, 390 (55%) had low numeracy skills and 258 (37%) had low literacy skills. Low numeracy was associated with increased odds of recidivism within 30 days (adjusted odds ratio, 1.41; 95% confidence interval, 1.00-1.98; P=0.048). For low health literacy, adjusted odds ratio of recidivism was 1.17 (95% confidence interval, 0.83-1.65; P=0.37). CONCLUSIONS: Low numeracy was associated with greater odds of 30-day recidivism. Further investigation is warranted to determine whether addressing numeracy and health literacy may reduce 30-day recidivism for patients with acute heart failure.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Douglas S Lee; Peter C Austin; Thérèse A Stukel; David A Alter; Alice Chong; John D Parker; Jack V Tu Journal: Am J Med Date: 2008-12-26 Impact factor: 4.965
Authors: Angela Fagerlin; Brian J Zikmund-Fisher; Peter A Ubel; Aleksandra Jankovic; Holly A Derry; Dylan M Smith Journal: Med Decis Making Date: 2007-07-19 Impact factor: 2.583
Authors: Gregory J Fermann; Phillip D Levy; Peter Pang; Javed Butler; S Imran Ayaz; Douglas Char; Patrick Dunn; Cathy A Jenkins; Christy Kampe; Yosef Khan; Vijaya A Kumar; JoAnn Lindenfeld; Dandan Liu; Karen Miller; W Frank Peacock; Samaa Rizk; Chad Robichaux; Russell L Rothman; Jon Schrock; Adam Singer; Sarah A Sterling; Alan B Storrow; Cheryl Walsh; John Wilburn; Sean P Collins Journal: Circ Heart Fail Date: 2017-02 Impact factor: 8.790
Authors: Sunil Kripalani; Kathryn Goggins; Sam Nwosu; Jonathan Schildcrout; Amanda S Mixon; Candace McNaughton; Amanda M McDougald Scott; Kenneth A Wallston Journal: J Health Commun Date: 2015
Authors: Richard T Griffey; Candace D McNaughton; Danielle M McCarthy; Erica Shelton; Ana Castaneda-Guarderas; Angela Young-Brinn; Donna Fowler; Corita Grudszen Journal: Acad Emerg Med Date: 2016-11-25 Impact factor: 3.451
Authors: Matteo Fabbri; Kathleen Yost; Lila J Finney Rutten; Sheila M Manemann; Cynthia M Boyd; Daniel Jensen; Susan A Weston; Ruoxiang Jiang; Véronique L Roger Journal: Mayo Clin Proc Date: 2017-12-06 Impact factor: 7.616
Authors: Bryan D James; Robert S Wilson; Raj C Shah; Lei Yu; Zoe Arvanitakis; David A Bennett; Patricia A Boyle Journal: Med Care Date: 2018-07 Impact factor: 2.983
Authors: Madeline R Sterling; Monika M Safford; Kathryn Goggins; Sam K Nwosu; Jonathan S Schildcrout; Kenneth A Wallston; Amanda S Mixon; Russell L Rothman; Sunil Kripalani Journal: J Hosp Med Date: 2018-02-12 Impact factor: 2.960