Jensen Katharine V, Morrison Andrea, Ma Keon, Alqurashi Waleed, Erickson Tannis, Curran Janet, Goldman Ran D, Gouin Serge, Kam April, Poonai Naveen, Principi Tania, Scott Shannon, Stang Antonia, Candelaria Patricia, Schreiner Kurt, Yaskina Maryna, Ali Samina
Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Women & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada.
CJEM. 2025 Jan;27(1):17-26. doi: 10.1007/s43678-024-00771-8. Epub 2024 Sep 27.
Caregivers with low health literacy are more likely to overestimate illness severity and have poor adherence with health-promoting behaviors. Our primary objective was to relate caregiver health literacy to the urgency of emergency department (ED) utilization. The secondary objective was to explore the relationship between social and demographic characteristics, health literacy, and urgency of ED use.
This sub-study was a descriptive cross-sectional survey with health record review. Data were collected from ten Canadian pediatric EDs. Study variables included demographics, visit details, and the Newest Vital Sign measurement of health literacy. ED visits were classified as urgent or non-urgent based on the resource utilization method.
The response rate was 97.6% (n = 2005). Mean (SD) caregiver age was 37.0 (7.7) years, 74.3% (n = 1950) were mothers, 72.6% (n = 1953) spoke English as a primary language, 51.0% (n = 1946) had a university degree, and 45.1% (n = 1699) had a household income greater than $100,000. The mean (SD) age of the children was 5.9 (5.0) years and 48.1% (n = 1956) were female. 43.7% (n = 1957) of caregivers had low health literacy. Being a caregiver with a child < 2 years old [aOR 1.83 (1.35, 2.48)] and low health literacy [aOR 1.56 (1.18, 2.05)] were associated with greater non-urgent pediatric ED use. Interprovincial variation was evident: Quebec caregivers were less likely to use the pediatric ED for non-urgent presentations compared to Alberta, while those in Nova Scotia, Manitoba, British Columbia, and Ontario were more likely compared to Alberta.
Almost half of caregivers presenting to Canadian pediatric EDs have low health literacy, which may limit their ability to make appropriate healthcare decisions for their children. Low caregiver health literacy is a modifiable factor associated with increased non-urgent ED utilization. Efforts to address this may positively influence ED utilization.
健康素养较低的照顾者更有可能高估疾病严重程度，且对促进健康行为的依从性较差。我们的主要目的是将照顾者的健康素养与急诊科（ED）就诊的紧急程度联系起来。次要目的是探讨社会和人口特征、健康素养与ED使用紧急程度之间的关系。
本亚研究是一项带有健康记录审查的描述性横断面调查。数据从加拿大的10个儿科急诊科收集。研究变量包括人口统计学、就诊细节以及健康素养的最新生命体征测量。根据资源利用方法，将ED就诊分为紧急或非紧急。
回复率为97.6%（n = 2005）。照顾者的平均（标准差）年龄为37.0（7.7）岁，74.3%（n = 1950）是母亲，72.6%（n = 1953）以英语作为主要语言，51.0%（n = 1946）拥有大学学位，45.1%（n = 1699）家庭收入超过10万美元。儿童的平均（标准差）年龄为5.9（5.0）岁，48.1%（n = 1956）为女性。43.7%（n = 1957）的照顾者健康素养较低。照顾2岁以下儿童的照顾者[aOR 1.83（1.35，2.48）]以及健康素养较低的照顾者[aOR 1.56（1.18，2.05）]与更多的非紧急儿科ED就诊相关。省际差异明显：与艾伯塔省相比，魁北克省的照顾者因非紧急情况使用儿科ED的可能性较小，而与艾伯塔省相比，新斯科舍省、曼尼托巴省、不列颠哥伦比亚省和安大略省的照顾者使用儿科ED的可能性更大。
前往加拿大儿科ED就诊的照顾者中，近一半健康素养较低，这可能会限制他们为孩子做出适当医疗保健决策的能力。照顾者健康素养低是与非紧急ED就诊增加相关的一个可改变因素。解决这一问题的努力可能会对ED的使用产生积极影响。
