Children's Mercy Kansas City, Kansas City, Missouri.
University of Missouri Kansas City School of Medicine, Kansas City, Missouri.
Hosp Pediatr. 2024 Oct 1;14(10):e426-e431. doi: 10.1542/hpeds.2023-007663.
Health literacy is the ability to find, understand, and use information and services to inform health-related decisions and actions. Inadequate health literacy is associated with health disparities, poor health outcomes, and increased emergency department (ED) visits and hospitalizations. Children with medical complexity (CMC) have high rates of acute health care utilization. We examined the association of parental health literacy with acute care utilization and costs in CMC.
This cross-sectional study included parents of CMC receiving primary care at a free-standing children's hospital. We measured parental health literacy using the Single Item Literacy Screener, which measures the assistance needed to read health care materials. Our main predictor was parental health literacy, categorized as adequate versus inadequate. In a sensitivity analysis, we categorized health literacy as never needing assistance versus needing any assistance. Main outcomes were annual ED visits, hospitalizations, and associated costs.
Of the 236 parents of CMC, 5.5% had inadequate health literacy. Health literacy was not associated with acute care utilization or associated costs. In our sensitivity analysis, CMC whose parents need any assistance to read health care materials had 188% higher ED costs (adjusted rate ratio 2.88 [95% confidence interval: 1.63-5.07]) and 126% higher hospitalization costs (adjusted rate ratio 2.26 [95% confidence interval: 1.49-3.44]), compared with CMC whose parents never need assistance.
Inadequate parental health literacy was not associated with acute care utilization. However, CMC of parents needing any assistance to read health materials had higher ED and hospitalization costs. Further multicenter studies are needed.
健康素养是指查找、理解和使用信息及服务以做出与健康相关决策并采取相应行动的能力。健康素养不足与健康差异、不良健康结局以及急诊就诊次数和住院增加有关。患有复杂型医疗状况（CMC）的儿童对急性医疗保健的利用率较高。我们调查了父母的健康素养与 CMC 患者的急性护理利用率和费用之间的关联。
本横断面研究纳入了在一家独立儿童医院接受初级保健的 CMC 患儿的父母。我们使用单项目识字筛查工具（Single Item Literacy Screener）来衡量父母的健康素养，该工具用于衡量阅读医疗保健材料所需的帮助。我们的主要预测指标是父母的健康素养，分为足够和不足两个类别。在敏感性分析中，我们将健康素养分为从未需要帮助和需要任何帮助两个类别。主要结局是每年的急诊就诊次数、住院次数和相关费用。
在 236 名 CMC 患儿的父母中，有 5.5%的人健康素养不足。健康素养与急性护理利用率或相关费用无关。在敏感性分析中，父母需要任何帮助才能阅读医疗材料的 CMC 患儿的急诊就诊费用高出 188%（调整后比率比 2.88 [95%置信区间：1.63-5.07]），住院费用高出 126%（调整后比率比 2.26 [95%置信区间：1.49-3.44]）。
父母健康素养不足与急性护理利用率无关。然而，父母需要任何帮助才能阅读医疗材料的 CMC 患儿的急诊就诊和住院费用更高。需要进一步开展多中心研究。
