Joseph Boyle1, Theodore Speroff2,3,4,5,6, Katherine Worley3, Aize Cao7, Kathryn Goggins3,4,8, Robert S Dittus2,3,4,6, Sunil Kripalani9,4,6,8. 1. School of Graduate Medical Education, University of Colorado, Aurora, Colorado, USA. 2. Department of Veterans Affairs, Tennessee Valley Healthcare System Geriatric Research Education and Clinical Center (GRECC), Nashville, Tennessee, USA. 3. Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 4. Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 5. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 6. Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 7. Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 8. Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 9. Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA. sunil.kripalani@vanderbilt.edu.
Abstract
OBJECTIVE: To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. DESIGN, SETTING, PARTICIPANTS: A cross-sectional analysis of patients admitted to an academic medical center. MEASUREMENTS: Nurses administered the Brief Health Literacy Screen and documented TCNs along 10 domains: caregiver support, transportation, healthcare utilization, high-risk medical comorbidities, medication management, medical devices, functional status, mental health comorbidities, communication, and financial resources. RESULTS: Among the 384 patients analyzed, 113 (29%) had inadequate health literacy. Patients with inadequate health literacy had needs in more TCN domains (mean = 5.29 vs 4.36; P < 0 .001). In unadjusted analysis, patients with inadequate health literacy were significantly more likely to have TCNs in 7 out of the 10 domains. In multivariate analyses, inadequate health literacy remained significantly associated with inadequate caregiver support (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.37-4.99) and transportation barriers (OR, 1.69; 95% CI, 1.04-2.76). CONCLUSIONS: Among hospitalized patients, inadequate health literacy is prevalent and independently associated with other needs that place patients at a higher risk of adverse outcomes, such as hospital readmission. Screening for inadequate health literacy and associated needs may enable hospitals to address these barriers and improve postdischarge outcomes.
OBJECTIVE: To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. DESIGN, SETTING, PARTICIPANTS: A cross-sectional analysis of patients admitted to an academic medical center. MEASUREMENTS: Nurses administered the Brief Health Literacy Screen and documented TCNs along 10 domains: caregiver support, transportation, healthcare utilization, high-risk medical comorbidities, medication management, medical devices, functional status, mental health comorbidities, communication, and financial resources. RESULTS: Among the 384 patients analyzed, 113 (29%) had inadequate health literacy. Patients with inadequate health literacy had needs in more TCN domains (mean = 5.29 vs 4.36; P < 0 .001). In unadjusted analysis, patients with inadequate health literacy were significantly more likely to have TCNs in 7 out of the 10 domains. In multivariate analyses, inadequate health literacy remained significantly associated with inadequate caregiver support (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.37-4.99) and transportation barriers (OR, 1.69; 95% CI, 1.04-2.76). CONCLUSIONS: Among hospitalized patients, inadequate health literacy is prevalent and independently associated with other needs that place patients at a higher risk of adverse outcomes, such as hospital readmission. Screening for inadequate health literacy and associated needs may enable hospitals to address these barriers and improve postdischarge outcomes.
Authors: Hanna Vollbrecht; Vineet Arora; Sebastian Otero; Kyle Carey; David Meltzer; Valerie G Press Journal: J Med Internet Res Date: 2020-06-04 Impact factor: 5.428
Authors: James T Rague; Soojin Kim; Josephine A Hirsch; Theresa Meyer; Ilina Rosoklija; Jill E Larson; Vineeta T Swaroop; Robin M Bowman; Diana K Bowen; Earl Y Cheng; Elisa J Gordon; Daniel I Chu; Tamara Isakova; Elizabeth B Yerkes; David I Chu Journal: JAMA Netw Open Date: 2021-09-01