Schaeffer Doris, Griese Lennert, Klinger Julia
Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Germany.
Wirtschafts- und Sozialwissenschaftliche Fakultät, Universität zu Köln, Institut für Soziologie und Sozialpsychologie, Köln, Germany.
Gesundheitswesen. 2024 Jan;86(1):59-66. doi: 10.1055/a-2148-5221. Epub 2023 Oct 9.
Many health care systems are characterized by their high complexity and intransparency. Finding one's way through the multitude of services and finding the right place requires high navigational health literacy (NHL). NHL is defined as the ability to manoeuvre through the health care system and deal with the information required to do so. However, so far, there has been a lack of data on the population's NHL. The objective of this article is to analyse empirically the NHL in Germany and its association with socio-demographic and economic factors.
NHL was surveyed with an instrument (HLS-NAV) newly developed by an international working group, measuring the self-assessed difficulties in relation to 12 navigation-related information tasks. The HLS-NAV has already been used in 8 countries, including Germany. In Germany, data on NHL was collected from 2,151 adult residents in a representative cross-sectional study. The relationship between socio-demographic and economic factors, and NHL was examined by using methods of analysis of variance and multivariate linear regression analysis.
Approximately 80% of the respondents showed low NHL with a mean score of 41.5 out of a possible 100 points. Those with low socio-economic resources, people of advanced age, people who had migrated to Germany or who were limited by health issues had a particularly low NHL. However, even people with good resources had a relatively low NHL. In contrast, the mean score was significantly higher among health professionals.
In recent years, numerous efforts have been made to reduce navigational difficulties and to better guide patients through the German health care system. However, according to the results of the study, there is still need for further action. Above all, structural measures are required: this includes the creation of sufficient, reliable information on the health care system and its organizations as well as the implementation of navigation aids, health care pathways and the creation of a health-literate health care system including organizations and health professionals that contribute to strengthening NHL in general.
许多医疗保健系统具有高度复杂性和不透明性。在众多服务中找到方向并找到合适的地方需要较高的健康导航素养(NHL)。NHL被定义为在医疗保健系统中灵活应对并处理所需信息的能力。然而,到目前为止,缺乏关于人群NHL的数据。本文的目的是对德国的NHL及其与社会人口和经济因素的关联进行实证分析。
使用国际工作组新开发的一种工具(HLS-NAV)对NHL进行调查,该工具测量与12项与导航相关的信息任务相关的自我评估困难。HLS-NAV已在包括德国在内的8个国家使用。在德国,通过一项具有代表性的横断面研究从2151名成年居民中收集了NHL数据。使用方差分析和多元线性回归分析方法研究社会人口和经济因素与NHL之间的关系。
约80%的受访者显示出较低的NHL,平均得分为41.5分(满分100分)。社会经济资源匮乏的人、老年人、移民到德国的人或受健康问题限制的人NHL特别低。然而,即使是资源良好的人NHL也相对较低。相比之下,卫生专业人员的平均得分明显更高。
近年来,为减少导航困难并更好地引导患者通过德国医疗保健系统做出了许多努力。然而,根据研究结果,仍需进一步行动。最重要的是需要采取结构性措施:这包括创建关于医疗保健系统及其组织的充分、可靠信息,以及实施导航辅助工具、医疗保健路径,并创建一个具有健康素养的医疗保健系统,包括有助于总体加强NHL的组织和卫生专业人员。