El efecto Fausto: sobre la legibilidad y comprensión de los informes clínicos de alta hospitalaria

Abstract

Inadequate comprehension of the discharge report can have serious repercussions. Reading difficulty hampers communication and has been related to increased healthcare costs and poor therapeutic compliance, among other factors. The readability of hospital discharge reports in Spain is unknown. The aim of the present study was to demonstrate that the readability of discharge reports is lower than recommended standards and that readability is probably associated with the writing style used. We reviewed 166 discharge reports from an internal medicine department. The discharge reports were classified in 2 subgroups according to the writing style used: a) descriptive (characterised by continuous and exhaustive details of technical data), and b) narrative (based on expressions that were a priori simpler and less quantitative). Readability was determined through the Flesch Index and a count of technical terms that patients would find unfamiliar (including abbreviations). The mean Flesch Index score for all the discharge reports was 53 points, which was much lower than the recommended readability level. This difference was more evident in the descriptive than in the narrative subgroup. Descriptive reports contained more technical terms than did narrative reports. In conclusion, the reading difficulty of the discharge reports exceeds the reading level of most patients. Narrative style is more easily understood than descriptive style.