Bourne Allison, Peerbux Shehzaad, Jessup Rebecca, Staples Margaret, Beauchamp Alison, Buchbinder Rachelle
Monash Department of Clinical Epidemiology, Cabrini Institute, 4 Drysdale Street, Malvern, VIC, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia.
BMC Health Serv Res. 2018 Nov 20;18(1):877. doi: 10.1186/s12913-018-3697-2.
Health service providers should understand and attend to the health literacy needs of their population in view of the known association between low health literacy and poorer health outcomes. This study aimed to determine the health literacy profile of patients treated at a large private hospital in Melbourne, Australia, and any associations between this profile and socio-economic position, health behaviours, health status and use of hospital services.
A mailed survey was sent to 9173 people aged ≥18 years with a hospital admission between February and October 2014. It included the Health Literacy Questionnaire (HLQ), a multidimensional tool comprising nine independent scales, and socio-demographic and clinical questions. For both respondents and non-respondents, we also extracted residential postcode and admission and follow up details from the Patient Administrative Services database. Differences in demographic, socio-economic and hospital use patterns between respondents and non-respondents were analysed using descriptive statistics. Regression-tests were used to identify differences in health literacy between socio-economic subgroups, with the magnitude of these differences determined using Cohen's d effect sizes.
There were 3121 respondents (response rate: 35% excluding 154 returned invitations), the majority born in Australia (74.6%) and living in areas of high socio-economic advantage. Respondents were slightly older than non-respondents (mean (SD) age 65.6 (17.0) versus 60.6 (20.8) years) and included proportionately less females (51.9 versus 59.1%) but were similar with regard to other socio-demographic factors and health service use. Participants who did not speak English at home, reported lower scores across several HLQ scales, including those that measure health provider support and engagement. Those who smoked and reported low physical activity had lower scores for actively managing their health. No relationship was seen between HLQ scale scores and use of hospital services.
Based upon the health literacy profile of a large cohort of patients attending a large private hospital, we found no relationship between HLQ scale scores and use of hospital services. However we did identify significant health literacy needs particularly among patients whose primary language at home was not English and patients needing assistance completing the survey. Identifying ways of addressing these needs may improve patient outcomes.
鉴于健康素养低与较差的健康结果之间存在已知关联，医疗服务提供者应了解并关注其服务人群的健康素养需求。本研究旨在确定澳大利亚墨尔本一家大型私立医院接受治疗的患者的健康素养概况，以及该概况与社会经济地位、健康行为、健康状况和医院服务使用之间的任何关联。
向9173名年龄≥18岁且在2014年2月至10月期间入院的患者发送了邮寄调查问卷。问卷包括健康素养问卷（HLQ），这是一种多维工具，由九个独立量表以及社会人口统计学和临床问题组成。对于受访者和未受访者，我们还从患者管理服务数据库中提取了居住邮政编码、入院和随访详细信息。使用描述性统计分析受访者和未受访者在人口统计学、社会经济和医院使用模式方面的差异。回归测试用于确定社会经济亚组之间健康素养的差异，这些差异的大小使用科恩d效应量来确定。
有3121名受访者（回复率：排除154份退回邀请后为35%），大多数出生在澳大利亚（74.6%），生活在社会经济优势较高的地区。受访者比未受访者年龄稍大（平均（标准差）年龄65.6（17.0）岁对60.6（20.8）岁），女性比例相对较低（51.9%对59.1%），但在其他社会人口统计学因素和医疗服务使用方面相似。在家不说英语的参与者在HLQ的几个量表上得分较低，包括那些衡量医疗服务提供者支持和参与度的量表。吸烟且报告身体活动少的人在积极管理自身健康方面得分较低。未发现HLQ量表得分与医院服务使用之间存在关系。
根据一大群在大型私立医院就诊的患者的健康素养概况，我们发现HLQ量表得分与医院服务使用之间没有关系。然而，我们确实确定了显著的健康素养需求，特别是在母语不是英语的患者以及需要协助完成调查的患者中。确定满足这些需求的方法可能会改善患者的治疗结果。
