Baker D W, Parker R M, Williams M V, Clark W S
Department of Medicine and Department of Epidemiology and Biostatistics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109-1998, USA.
J Gen Intern Med. 1998 Dec;13(12):791-8. doi: 10.1046/j.1525-1497.1998.00242.x.
To determine the association between patient literacy and hospitalization.
Prospective cohort study.
Urban public hospital.
A total of 979 emergency department patients who participated in the Literacy in Health Care study and had completed an intake interview and literacy testing with the Test of Functional Health Literacy in Adults were eligible for this study. Of these, 958 (97.8%) had an electronic medical record available for 1994 and 1995.
Hospital admissions to Grady Memorial Hospital during 1994 and 1995 were determined by the hospital information system. We used multivariate logistic regression to determine the independent association between inadequate functional health literacy and hospital admission. Patients with inadequate literacy were twice as likely as patients with adequate literacy to be hospitalized during 1994 and 1995 (31. 5% vs 14.9%, p <.001). After adjusting for age, gender, race, self-reported health, socioeconomic status, and health insurance, patients with inadequate literacy were more likely to be hospitalized than patients with adequate literacy (adjusted odds ratio [OR] 1.69; 95% confidence interval [CI] 1.13, 2.53). The association between inadequate literacy and hospital admission was strongest among patients who had been hospitalized in the year before study entry (OR 3.15; 95% CI 1.45, 6.85).
In this study population, patients with inadequate functional health literacy had an increased risk of hospital admission.
确定患者读写能力与住院治疗之间的关联。
前瞻性队列研究。
城市公立医院。
共有979名急诊科患者参与了医疗保健读写能力研究，并完成了成人功能性健康读写能力测试的入院访谈和读写能力测试，符合本研究要求。其中，958名（97.8%）患者在1994年和1995年有电子病历。
1994年和1995年格雷迪纪念医院的住院情况由医院信息系统确定。我们使用多变量逻辑回归来确定功能性健康读写能力不足与住院之间的独立关联。读写能力不足的患者在1994年和1995年住院的可能性是读写能力充足患者的两倍（31.5%对14.9%，p<.001）。在调整年龄、性别、种族、自我报告的健康状况、社会经济地位和医疗保险后，读写能力不足的患者比读写能力充足的患者更有可能住院（调整后的优势比[OR]为1.69；95%置信区间[CI]为1.13，2.53）。在研究入组前一年曾住院的患者中，读写能力不足与住院之间的关联最为强烈（OR为3.15；95%CI为1.45，6.85）。
在本研究人群中，功能性健康读写能力不足的患者住院风险增加。
