Impact of low health literacy on healthcare utilization in individuals with cardiovascular disease, chronic obstructive pulmonary disease, diabetes and mental disorders. A Danish population-based 4-year follow-up study.
Journal
European journal of public health
ISSN: 1464-360X
Titre abrégé: Eur J Public Health
Pays: England
ID NLM: 9204966
Informations de publication
Date de publication:
01 10 2020
01 10 2020
Historique:
pubmed:
27
4
2020
medline:
25
6
2021
entrez:
27
4
2020
Statut:
ppublish
Résumé
Previous research from the USA has shown that low health literacy is associated with higher hospitalization rates and higher rates of emergency service use. However, studies in a European context using more comprehensive health literacy definitions are lacking. The aim was to study the impact of low health literacy on healthcare utilization in a Danish context. In this prospective cohort study, baseline survey data from 2013 were derived from a large Danish health and morbidity survey and merged with individual-level longitudinal register data for a 4-year follow-up period. The study included people in the general population (n = 29 473) and subgroups of people with four different chronic conditions: cardiovascular disease (CVD) (n = 2389), chronic obstructive pulmonary disease (COPD) (n = 1214), diabetes (n = 1685) and mental disorders (n = 1577). In the general population, low health literacy predicted slightly more visits to the general practitioner and admissions to hospital and longer hospitalization periods at 4 years of follow-up, whereas low health literacy did not predict planned outpatient visits or emergency room visits. In people with CVD, low health literacy predicted more days with emergency room visits. In people with mental disorders, difficulties in actively engaging with healthcare providers were associated with a higher number of hospital admission days. No significant association between health literacy and healthcare utilization was found for diabetes or COPD. Even though Denmark has a universal healthcare system the level of health literacy affects healthcare use in the general population and in people with CVD and mental disorders.
Sections du résumé
BACKGROUND
Previous research from the USA has shown that low health literacy is associated with higher hospitalization rates and higher rates of emergency service use. However, studies in a European context using more comprehensive health literacy definitions are lacking. The aim was to study the impact of low health literacy on healthcare utilization in a Danish context.
METHODS
In this prospective cohort study, baseline survey data from 2013 were derived from a large Danish health and morbidity survey and merged with individual-level longitudinal register data for a 4-year follow-up period. The study included people in the general population (n = 29 473) and subgroups of people with four different chronic conditions: cardiovascular disease (CVD) (n = 2389), chronic obstructive pulmonary disease (COPD) (n = 1214), diabetes (n = 1685) and mental disorders (n = 1577).
RESULTS
In the general population, low health literacy predicted slightly more visits to the general practitioner and admissions to hospital and longer hospitalization periods at 4 years of follow-up, whereas low health literacy did not predict planned outpatient visits or emergency room visits. In people with CVD, low health literacy predicted more days with emergency room visits. In people with mental disorders, difficulties in actively engaging with healthcare providers were associated with a higher number of hospital admission days. No significant association between health literacy and healthcare utilization was found for diabetes or COPD.
CONCLUSIONS
Even though Denmark has a universal healthcare system the level of health literacy affects healthcare use in the general population and in people with CVD and mental disorders.
Identifiants
pubmed: 32335677
pii: 5825342
doi: 10.1093/eurpub/ckaa064
pmc: PMC7536249
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
866-872Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.
Références
Acad Emerg Med. 2017 Sep;24(9):1042-1050
pubmed: 28646519
Int J Health Policy Manag. 2015 Aug 17;4(11):747-55
pubmed: 26673335
Health Lit Res Pract. 2018 Jun 12;2(2):e115-e122
pubmed: 31294284
Front Psychiatry. 2018 Sep 28;9:463
pubmed: 30323773
Patient Educ Couns. 2014 Feb;94(2):149-57
pubmed: 24207115
Mayo Clin Proc. 2018 Jan;93(1):9-15
pubmed: 29217337
Eur J Prev Cardiol. 2017 Nov;24(17):1880-1888
pubmed: 28854822
JAMA Psychiatry. 2015 Apr;72(4):334-41
pubmed: 25671328
Eur J Public Health. 2014 Dec;24(6):997-1003
pubmed: 24367063
J Health Commun. 2011;16 Suppl 3:308-21
pubmed: 21951260
Health Educ Behav. 2009 Oct;36(5):860-77
pubmed: 18728119
Acad Emerg Med. 2014 Oct;21(10):1109-15
pubmed: 25308133
J Epidemiol Community Health. 2016 Oct;70(10):1032-8
pubmed: 27116951
Scand J Public Health. 2011 Jul;39(7 Suppl):30-3
pubmed: 21775347
Springerplus. 2016 Aug 02;5(1):1232
pubmed: 27536516
Am J Health Behav. 2008 May-Jun;32(3):227-42
pubmed: 18067463
JAMA. 2011 Apr 27;305(16):1695-701
pubmed: 21521851
Scand J Public Health. 2011 Jul;39(7 Suppl):34-7
pubmed: 21775348
Soc Work Public Health. 2016 Oct;31(6):467-73
pubmed: 27175556
J Diabetes Res. 2016;2016:7823130
pubmed: 27761473
J Gen Intern Med. 2013 Sep;28(9):1174-80
pubmed: 23478997
J Card Fail. 2015 Aug;21(8):612-8
pubmed: 25908018
BMC Public Health. 2013 Jul 16;13:658
pubmed: 23855504
J Gen Intern Med. 2004 Mar;19(3):215-20
pubmed: 15009775
BMJ Open. 2016 Jan 14;6(1):e009627
pubmed: 26769783
J Gen Intern Med. 2015 Oct;30(10):1538-46
pubmed: 25917656
J Am Heart Assoc. 2015 Apr 29;4(5):
pubmed: 25926328
BMJ Open. 2015 Jun 11;5(6):e006975
pubmed: 26068508
Soc Sci Med. 2008 Apr;66(8):1809-16
pubmed: 18295949
Scand J Public Health. 2012 Nov;40(8 Suppl):12-105
pubmed: 23147863
Interact J Med Res. 2014 Feb 10;3(1):e3
pubmed: 24513479
J Adv Nurs. 2009 Aug;65(8):1570-83
pubmed: 19493137
Med Care. 2013 Aug;51(8):654-8
pubmed: 23703649
BMC Public Health. 2010 Oct 16;10:614
pubmed: 20950479