Examining the impacts of health literacy on healthcare costs. An evidence synthesis

2017 ◽  
Vol 30 (4) ◽  
pp. 197-212 ◽  
Author(s):  
Rocco Palumbo
Keyword(s):  
Health Literacy ◽  
Healthcare Costs ◽  
Access To Health Care ◽  
Evidence Synthesis ◽  
Cost Savings ◽  
Point Of View ◽  
Organizational Strategies ◽  
Limited Health Literacy ◽  
Health Related ◽  
Limited Health

Scholars and practitioners share a significant concern about rising healthcare costs. Health literacy is widely presented as a solution to this momentous issue, paving the way for a more appropriate access to care and therefore, for cost savings. However, to date little is still known about the ultimate effects of better health literacy on healthcare costs. Drawing from the findings of a systematic literature review which ultimately involved 29 papers retrieved from Scopus-Elsevier and PubMed. This manuscript is aimed at shedding light on the relationship between health literacy and healthcare costs. The inadequate ability of patients to understand health information and to navigate the healthcare system was found to be an important predictor of inappropriateness in the access to health care. In addition, people living with problematic health literacy are discouraged to be engaged in the provision of health services and are expected to show poor self-efficacy in dealing with their health-related conditions. From this point of view, poor health literate patients are assumed to be at high risk of exacerbation of their health problems, which in turn contributes in rising healthcare costs. In spite of these findings, both policy makers and practitioners seem to overlook the importance of health literacy. Eventually, the joint intervention on laws, policies, organizational strategies, and practices is crucial to handle the challenges related to limited health literacy.

scholarly journals Limited Health Literacy in Portugal Assessed with the Newest Vital Sign

2017 ◽  
Vol 30 (12) ◽  
pp. 861 ◽  
Author(s):  
Dagmara Paiva ◽  
Susana Silva ◽  
Milton Severo ◽  
Pedro Moura-Ferreira ◽  
Nuno Lunet ◽  
...  
Keyword(s):  
Health Literacy ◽  
Vital Sign ◽  
High Reliability ◽  
Portuguese Population ◽  
Limited Health Literacy ◽  
Sociodemographic Correlates ◽  
Health Related ◽  
Newest Vital Sign ◽  
Limited Health ◽  
Related Occupation

Introduction: In Portugal, health literacy has started to be addressed through national policies, but research on the topic is still scarce. We aimed to estimate the prevalence and sociodemographic correlates of limited health literacy in Portugal using an existing health literacy instrument, the Newest Vital Sign.Materials and Methods: Following cross-cultural adaptation of the instrument, a sample of 249 participants was evaluated to assess reliability and construct validity of the Newest Vital Sign; the latter was tested assuming physicians would score highest, followed by health researchers, then by engineering researchers and finally by laypersons from the general population. We applied this validated version in a representative sample of 1544 Portuguese-speaking residents in Portugal aged between 16 and 79 years and quantified the associations between limited health literacy and sociodemographic characteristics.Results: The instrument showed high reliability (Cronbach’s α = 0.85). Health-related occupation showed association with higher scores in the Newest Vital Sign (p trend < 0.001). The prevalence of limited health literacy in the Portuguese population was 72.9% (95% CI: 69.4 - 76.4). We found no differences between men and women, but persons with limited health literacy were significantly older (p < 0.001) and less educated (p < 0.001).Discussion: The burden of limited health literacy in Portugal is higher than that in other European countries. It should drive a universal precautions approach to health communication at all levels of the health system.Conclusion: We validated a brief and simple instrument and estimated the prevalence of limited health literacy in the literate Portuguese population at roughly three out of four people.

The missing link to patient engagement in Italy

2016 ◽  
Vol 30 (8) ◽  
pp. 1183-1203 ◽  
Author(s):  
Rocco Palumbo ◽  
Carmela Annarumma ◽  
Paola Adinolfi ◽  
Marco Musella
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Patient Engagement ◽  
Care Service ◽  
Health Care Service ◽  
Content Type ◽  
Limited Health Literacy ◽  
Health Related ◽  
Limited Health ◽  
Inadequate Health Literacy

Purpose The purpose of this paper is to discuss the changing patterns of users’ behavior in the health care service system. Although patient engagement and health services’ co-production are understood as essential ingredients in the recipe for sustainable health systems, some determinants to patient involvement are still widely neglected by both policy makers and health care professionals. Among others, inadequate health literacy performs as a significant barrier to patient empowerment. Design/methodology/approach A survey aimed at objectively measuring health literacy-related skills was administered to a random sample of 600 Italian patients. The Italian version of the Newest Vital Sign (NVS) was used to assess the ability of the respondents to deal with written health information. Moreover, the respondents were asked to self-report their ability to navigate the health system. It was presumed that inadequate health literacy as measured by the NVS is related with impaired self-reported functional, interactive, and critical health-related competencies, paving the way for the inability and the unwillingness of patients to be involved in the health care provision. Findings About half of the sample showed inadequate health literacy. However, poor NVS scores were only slightly associated with limited self-reported functional, interactive, and critical health-related competencies. In general, patients with inadequate health-related skills were not likely to be engaged in the provision of health services. Elderly, people suffering from financial deprivation and less educated individuals were found to be at special risk of living with limited health literacy. Practical implications Limited health literacy is a common and relevant issue among people dealing with the health care service system. The impaired ability to collect, process, and use health information produces barriers to patient engagement and prevents the evolution of patients’ behavior toward health care co-production. Originality/value Health literacy is a widely overlooked issue in the Italian national health system. This paper contributes in shedding light on the determinants and effects of health literacy of Italian hospital patients. Besides, some insights on the validity of the methodological tools typically used to assess health-related skills are provided.

scholarly journals Information about organ donation: the perspective of people with limited health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Rademakers ◽  
M Rolink ◽  
M Heijmans
Keyword(s):  
Health Literacy ◽  
Organ Donation ◽  
Organ Donor ◽  
Specific Information ◽  
Limited Health Literacy ◽  
Individual Interviews ◽  
Health Related ◽  
The Law ◽  
Information Channels ◽  
Limited Health

Abstract Background In 2020, a new law on organ donation will come into force in the Netherlands. This law requires people to actively register their choice whether or not to be an organ donor after death. In this opt-out system, people who do not register themselves are automatically considered to be a donor. To inform the general public, the Dutch ministry of Health launched a communication campaign to inform the general audience. However, people with limited health literacy - 1 in three Dutch adults - have difficulties understanding health related information. Therefore, a study was performed to determine the appropriate information content and communication channels to better address the knowledge needs of this specific target group. Methods The study was done through (a) desk research and (b) 6 individual interviews and 4 focus groups with people with limited health literacy (total 30 people). The respondents were recruited through organisations that focus on specific populations with limited health literacy (limited reading and writing skills, minor intellectual disabilities, migrants). Results Most respondents had not heard about the new law on organ donation. Those who were aware of the law did not know what the law entails and what was required of them. The content of the information currently used were generally considered too difficult and abstract and did not give the respondents enough input on which to base a decision whether or not to be an organ donor. People with limited health literacy can mention specific topics on which they want information. Furthermore, they want practical help in registering their choice through the website. As information channels they prefer simple films and narratives of other people. Conclusions People with limited health literacy need more specific information on organ donation and what the new law entails. They have a preference for films and narratives. Furthermore, they need practical help in registering their choice. Key messages Current information on the new Dutch law on organ donation is too difficult and does not address the knowledge needs of people with limited health literacy. Films and narratives are preferred information channels of people with limited health literacy.

scholarly journals Limited Functional Health Literacy, Health Information Sources, and Health Behavior among Community-Dwelling Older Adults in Japan

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yuko Yoshida ◽  
Hajime Iwasa ◽  
Shu Kumagai ◽  
Takao Suzuki ◽  
Hideyo Yoshida
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Information Sources ◽  
Community Dwelling ◽  
Functional Health ◽  
Functional Health Literacy ◽  
Limited Health Literacy ◽  
Health Related ◽  
Limited Health ◽  
Health Information Sources

The objectives of this study were to explore how health information sources vary by functional health literacy levels and the relationship between health literacy and health behaviors among the old-old, community-dwelling adults. A cross-sectional study was used. The sample included 620 participants from a rural community in northern Japan. We used structured questionnaires to gather demographic information and assess health-related behaviors, information sources utilized, and functional health literacy. Functional health literacy scores were categorized into three groups, namely, low, middle, and high literacy. Individuals with limited health literacy were more likely to drink less alcohol, were less physically active, had less dietary variety, and had a low rate of medical check-ups. They were also less likely to use printed media, organization or medical procedure, electronic media, and accessed fewer health-related information sources. This study highlights the necessity of information tools that facilitate better access to information among older adults with limited health literacy.

scholarly journals Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea

2021 ◽  
Vol 18 (15) ◽  
pp. 7918
Author(s):  
Hye-Ri Shin ◽  
Eun-Young Choi ◽  
Su-Kyung Kim ◽  
Hee-Yun Lee ◽  
Young-Sun Kim
Keyword(s):  
Health Literacy ◽  
South Korea ◽  
Multinomial Logistic Regression ◽  
Preliminary Evidence ◽  
Community Dwelling ◽  
Related Factors ◽  
Limited Health Literacy ◽  
Frailty Status ◽  
Health Related ◽  
Limited Health

Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70–84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.

scholarly journals Health literacy and associated factors among undergraduates: A university-based cross-sectional study in Nepal

2021 ◽  
Vol 1 (11) ◽  
pp. e0000016
Author(s):  
Sandesh Bhusal ◽  
Rajan Paudel ◽  
Milan Gaihre ◽  
Kiran Paudel ◽  
Tara Ballav Adhikari ◽  
...  
Keyword(s):  
Health Literacy ◽  
Undergraduate Students ◽  
Self Esteem ◽  
Survey Questionnaire ◽  
Cross Sectional ◽  
Limited Health Literacy ◽  
Financial Status ◽  
Literacy Survey ◽  
Health Related ◽  
Limited Health

Health literacy is one of the most critical aspects of health promotion. Limited health literacy is also accounted for adverse health outcomes and a huge financial burden on society. However, a gap exists in the level of health literacy, especially among undergraduates. This study aimed to assess the levels of health literacy and its socio-demographic determinants among undergraduate students of Tribhuvan University, Nepal. A web-based cross-sectional survey was conducted among 469 undergraduate students from five institutes of Tribhuvan University, Nepal. The 16-item short version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) was used to measure students’ health literacy levels. Associated factors were examined using Chi-square tests followed by multivariate logistic regression analyses at the level of significance of 0.05. Nearly 61% of students were found to have limited health literacy (24.5% had “inadequate” and 36.3% had “problematic” health literacy). Female students (aOR = 1.6, 95% CI: 1.1–2.5), students from non-health related majors (aOR = 1.9, 95% CI: 1.2–3.0), students with unsatisfactory health status (aOR = 2.8, 95% CI: 1.7–4.5), students with poor financial status (aOR = 2.9, 95% CI: 1.2–6.8) and students with low self-esteem (aOR = 2.5, 95% CI: 1.5–4.1) were significantly more likely to have limited health literacy. The majority of the undergraduates were found to have limited health literacy. Gender, sector of study, self-rated health status, self-rated financial status, and self-esteem were significantly associated with limited health literacy. This study indicates university students should not be assumed to be health-literate and interventions to improve students’ health literacy especially for those whose majors are not health-related should be implemented. Further studies using a longer version of the health literacy survey questionnaire and qualitative methods to explore more on determinants of health literacy are recommended.

scholarly journals Malaysian Health Literacy: Scorecard Performance from a National Survey

2021 ◽  
Vol 18 (11) ◽  
pp. 5813
Author(s):  
Norrafizah Jaafar ◽  
Komathi Perialathan ◽  
Manimaran Krishnan ◽  
Nurashma Juatan ◽  
Masitah Ahmad ◽  
...  
Keyword(s):  
Health Literacy ◽  
Nationwide Survey ◽  
Population Based ◽  
Average Score ◽  
Future Health ◽  
Limited Health Literacy ◽  
Health Literacy Level ◽  
Prevention And Health Promotion ◽  
Literacy Level ◽  
Limited Health

Health literacy is an indicator of a society’s ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society’s current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains—healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)—albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.

scholarly journals Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel Boyer ◽  
Yannick Begin ◽  
Julie Dupont ◽  
Mathieu Rousseau-Gagnon ◽  
Nicolas Fernandez ◽  
...  
Keyword(s):  
Health Literacy ◽  
Observational Study ◽  
Health Information ◽  
Healthcare Providers ◽  
Significant Proportion ◽  
Good Health ◽  
Sufficient Information ◽  
Home Dialysis ◽  
Limited Health Literacy ◽  
Limited Health

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

Can Screening Items Identify Surgery Patients at Risk of Limited Health Literacy?

2007 ◽  
Vol 140 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Lorraine S. Wallace ◽  
David C. Cassada ◽  
Edwin S. Rogers ◽  
Michael B. Freeman ◽  
Oscar H. Grandas ◽  
...  
Keyword(s):  
At Risk ◽  
Health Literacy ◽  
Limited Health Literacy ◽  
Patients At Risk ◽  
Limited Health

scholarly journals AB0300 LUPUS DISEASE ACTIVITY CORRELATES WITH QUALITY OF LIFE BUT NOT WITH HEALTH LITERACY STATUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1176.2-1176
Author(s):  
E. Eraslan ◽  
R. Bilici Salman ◽  
H. Satiş ◽  
A. Avanoglu Guler ◽  
H. Karadeniz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Literacy ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Patient Reported Outcome ◽  
The Body ◽  
Limited Health Literacy ◽  
Patient Reported ◽  
Limited Health

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology that can affect any organ of the body. SLE is associated with adverse effects on both health and non-health-related quality of life (HRQOL and non-HRQOL). Lupus PRO is a patient reported outcome measure that has been validated in many languages. It has 44 items that cover both HRQOL and non-HRQOL (1). Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. Multiple studies indicate that people with limited health literacy have worse health status and higher rates of hospitalization (2).Objectives:We aimed to evaluate the relationship between the LLDAS (Lupus Low Disease Activity State) criteria and the Lupus PRO test, as well as the health literacy status of lupus patients.Methods:83 SLE patients (94% women) were included in the study. We performed Lupus PRO and the European Health Literacy Survey tests during the routine follow-up visits of lupus patients to our rheumatology outpatient clinic and admissions to rheumatology inpatient clinic. Available clinical data on medical records were obtained, physician global assessments (PGA) were recorded by the attending physician.Results:LLDAS criteria strongly and inversely correlated with the total score, as well as the mood subunit of the Lupus PRO. Similarly, it also significantly inversely correlated with the body appearence and goals subunits. Health literacy status of the patients did not correlate with their LLDAS scores, ie their disease activities.Conclusion:Our results suggest that lupus disease activity, assessed by LLDAS criteria, significantly correlates with measures of quality of life, spesicifically Lupus PRO test, but not with health literacy status. Further studies are needed to evaluate if health literacy is related with damage, hospitalization or mortality associated with lupus.References:[1]Jolly M, Pickard AS, Block JA, Kumar RB, Mikolaitis RA, Wilke CT, et al., editors. Disease-specific patient reported outcome tools for systemic lupus erythematosus. Seminars in arthritis and rheumatism; 2012: Elsevier.[2]Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. Journal of general internal medicine. 2005;20(2):175-84.Disclosure of Interests:None declared

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