Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 1998 Dec;13(12):791-8.
doi: 10.1046/j.1525-1497.1998.00242.x.

Health literacy and the risk of hospital admission

D W Baker  1 , R M Parker, M V Williams, W S Clark
Affiliations

Health literacy and the risk of hospital admission

D W Baker et al. J Gen Intern Med. 1998 Dec.

Abstract

Objective: To determine the association between patient literacy and hospitalization.

Design: Prospective cohort study.

Setting: Urban public hospital.

Patients: A total of 979 emergency department patients who participated in the Literacy in Health Care study and had completed an intake interview and literacy testing with the Test of Functional Health Literacy in Adults were eligible for this study. Of these, 958 (97.8%) had an electronic medical record available for 1994 and 1995.

Measurements and main results: Hospital admissions to Grady Memorial Hospital during 1994 and 1995 were determined by the hospital information system. We used multivariate logistic regression to determine the independent association between inadequate functional health literacy and hospital admission. Patients with inadequate literacy were twice as likely as patients with adequate literacy to be hospitalized during 1994 and 1995 (31. 5% vs 14.9%, p <.001). After adjusting for age, gender, race, self-reported health, socioeconomic status, and health insurance, patients with inadequate literacy were more likely to be hospitalized than patients with adequate literacy (adjusted odds ratio [OR] 1.69; 95% confidence interval [CI] 1.13, 2.53). The association between inadequate literacy and hospital admission was strongest among patients who had been hospitalized in the year before study entry (OR 3.15; 95% CI 1.45, 6.85).

Conclusions: In this study population, patients with inadequate functional health literacy had an increased risk of hospital admission.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Proportion of patients hospitalized during 1994 and 1995 according to literacy level. Literacy level determined by the Test of Functional Health Literacy in Adults;p < .001 for comparison of one or more admissions and p < .001 for comparison of two or more admissions.
Figure 2
Figure 2
Proportion of patients hospitalized during 1994 and 1995 according to literacy level for the 187 patients who reported having been hospitalized during the year before study entry. Literacy level determined by the Test of Functional Health Literacy in Adults;p < .001 for comparison of one or more admissions and p < .001 for comparison of two or more admissions.
See this image and copyright information in PMC

Comment in

  • Patient literacy. A barrier to quality of care.
    Roter DL, Rudd RE, Comings J. Roter DL, et al. J Gen Intern Med. 1998 Dec;13(12):850-1. doi: 10.1046/j.1525-1497.1998.00250.x. J Gen Intern Med. 1998. PMID: 9844085 Free PMC article. No abstract available.

References

    1. Kirsch I, Jungeblut A, Jenkins L, Kolstad A. A First Look at the Results of the National Adult Literacy Survey. Washington, DC:: National Center for Education, US Dept of Education;; 1993. Adult Literacy in America:
    1. Williams MV, Parker R, Baker D. Inadequate functional health literacy among patients at two public hospitals. JAMA. 1995;274:1677–82. - PubMed
    1. Baker DW, Parker RM, Williams MV, et al. The health care experience of patients with low literacy. Arch Fam Med. 1996;5:329–34. - PubMed
    1. Powers RD. Emergency department patient literacy and the readability of patient-directed materials. Ann Emerg Med. 1988;17:124–6. - PubMed
    1. Doak L, Doak C. Patient comprehension profiles: recent findings and strategies. Patient Couns Health Educ. 1980;2:101–6. - PubMed