Patient-reported health literacy scores are associated with readmissions following surgery.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
11 2020
Historique:
received: 13 02 2020
revised: 05 05 2020
accepted: 26 06 2020
pubmed: 20 7 2020
medline: 5 1 2021
entrez: 20 7 2020
Statut: ppublish

Résumé

Health literacy (HL) impacts medical care. We hypothesized that patients with low HL would have higher readmission rates following surgery. We conducted a prospective, multi-institutional study from 8/2015-6/2017 within the Veterans Affairs (VA) System including veterans who underwent general, vascular, or thoracic surgery. HL was assessed by Brief Health Literacy Screener and stratified into adequate vs. low. Patients were followed for 30 days post-discharge. Multivariable analyses examined correlations and logistic regression models adjusted for covariates. 736 patients were enrolled in the study; 98% (n = 722) completed the HL survey. At discharge, 33.2% of patients had low HL. The overall 30-day readmission rate was 16.3%, with a significant difference by HL (Adequate HL: 13.3% vs. Low HL: 22.5%, p < 0.01). After adjusting for clinical and demographic covariates, patients with low HL were 59% more likely to be readmitted (OR = 1.59, 95% CI = 1.02-2.50). Low HL is common among VA surgery patients and is associated with readmission. Future studies should be focused on interventions to target this vulnerable patient population.

Sections du résumé

BACKGROUND
Health literacy (HL) impacts medical care. We hypothesized that patients with low HL would have higher readmission rates following surgery.
METHODS
We conducted a prospective, multi-institutional study from 8/2015-6/2017 within the Veterans Affairs (VA) System including veterans who underwent general, vascular, or thoracic surgery. HL was assessed by Brief Health Literacy Screener and stratified into adequate vs. low. Patients were followed for 30 days post-discharge. Multivariable analyses examined correlations and logistic regression models adjusted for covariates.
RESULTS
736 patients were enrolled in the study; 98% (n = 722) completed the HL survey. At discharge, 33.2% of patients had low HL. The overall 30-day readmission rate was 16.3%, with a significant difference by HL (Adequate HL: 13.3% vs. Low HL: 22.5%, p < 0.01). After adjusting for clinical and demographic covariates, patients with low HL were 59% more likely to be readmitted (OR = 1.59, 95% CI = 1.02-2.50).
CONCLUSION
Low HL is common among VA surgery patients and is associated with readmission. Future studies should be focused on interventions to target this vulnerable patient population.

Identifiants

pubmed: 32682501
pii: S0002-9610(20)30425-6
doi: 10.1016/j.amjsurg.2020.06.071
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1138-1144

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest We have no conflicts of interests to disclose.

Auteurs

Samantha Baker (S)

University of Alabama at Birmingham, Birmingham, AL, USA; VA Birmingham Healthcare System, Birmingham, AL, USA. Electronic address: Sjbaker@uabmc.edu.

Emily Malone (E)

University of Alabama at Birmingham, Birmingham, AL, USA; VA Birmingham Healthcare System, Birmingham, AL, USA.

Laura Graham (L)

VA Palo Alto Healthcare Systems, Palo Alto, CA, USA; Stanford University, Stanford, CA, USA.

Elise Dasinger (E)

University of Alabama at Birmingham, Birmingham, AL, USA; VA Birmingham Healthcare System, Birmingham, AL, USA.

Tyler Wahl (T)

University of Alabama at Birmingham, Birmingham, AL, USA; VA Birmingham Healthcare System, Birmingham, AL, USA.

Ashley Titan (A)

VA Palo Alto Healthcare Systems, Palo Alto, CA, USA; Stanford University, Stanford, CA, USA.

Joshua Richman (J)

University of Alabama at Birmingham, Birmingham, AL, USA; VA Birmingham Healthcare System, Birmingham, AL, USA.

Laurel Copeland (L)

VA Central Western Massachusetts Healthcare System, Leeds, MA, USA.

Edith Burns (E)

Milwaukee VA Medical Center, Milwaukee, WI, USA.

Jeffrey Whittle (J)

Milwaukee VA Medical Center, Milwaukee, WI, USA.

Mary Hawn (M)

VA Palo Alto Healthcare Systems, Palo Alto, CA, USA; Stanford University, Stanford, CA, USA.

Melanie Morris (M)

University of Alabama at Birmingham, Birmingham, AL, USA; VA Birmingham Healthcare System, Birmingham, AL, USA.

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