Levy Helen, Janke Alex
a Institute for Social Research , University of Michigan , Ann Arbor , Michigan , USA.
b School of Medicine , Wayne State University , Detroit , Michigan , USA.
J Health Commun. 2016;21 Suppl 1(Suppl):43-50. doi: 10.1080/10810730.2015.1131776.
Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forgo needed care or to report difficulty finding a provider, even after we controlled for other factors, including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after we controlled for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way.
尽管健康素养低、医疗保险覆盖率低与健康状况不佳之间的关联已有充分记录，但几乎没有关于健康素养低与自我报告的就医机会之间关系的研究。本研究分析了一个具有全国代表性的大型样本，样本为年龄在50岁及以上的社区居住成年人，以估计健康素养低与自我报告的就医困难之间的关系。我们发现，即使在我们控制了其他因素，包括医疗保险覆盖情况、就业、种族/民族、贫困和一般认知功能之后，健康素养低的个体比健康素养充足的个体更有可能延迟或放弃所需的医疗服务，或报告难以找到医疗服务提供者。他们也更有可能没有固定的医疗服务来源，尽管在我们控制了其他因素后，这一结果仅具有微弱的显著性。结果表明，除了健康素养低在临床诊疗过程中造成的任何障碍外，健康素养低还会降低人们及时进入医疗保健系统的可能性。
