Health literacy of recently hospitalised patients: a cross-sectional survey using the Health Literacy Questionnaire (HLQ)

Rebecca L Jessup,Allison Bourne,Richard H Osborne,Rachelle Buchbinder,Alison Beauchamp

doi:10.1186/s12913-016-1973-6

Rebecca L Jessup, Allison Bourne + Show 3 more

Open Access

https://doi.org/10.1186/s12913-016-1973-6

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Abstract

BackgroundHealth literacy is simply defined as an individual’s ability to access, understand and use information in ways that promote and maintain good health. Lower health literacy has been found to be associated with increased emergency department presentations and potentially avoidable hospitalisations. This study aimed to determine the health literacy of hospital inpatients, and to examine if associations exist between different dimensions of their health literacy, sociodemographic characteristics and hospital services use.MethodsA written survey was sent to 3,252 people aged ≥18 years in English, Arabic, Chinese, Vietnamese, Italian or Greek. The survey included demographic and health questions, and the Health Literacy Questionnaire (HLQ). The HLQ is a multidimensional instrument comprising nine independent scales. Use of hospital services was measured by length of stay, number of admissions in 12 months and number of emergency department presentations. Effect size (ES) for standardised differences in means described the magnitude of differences in HLQ scale scores between demographic and socioeconomic groups.Results385 questionnaires were returned (13%); mean age 64 years (SD 17), 49% female. Aged ≥65 years (55%), using the Internet < once a month (37%), failure to complete high school (67%), low household income (39%), receiving means-tested government benefits (61%) and being from a culturally and linguistically diverse (CALD) background (24%), were all associated with lower scores in some health literacy scales. Being aged ≥65 years, not currently employed, receiving government benefits, and being from a CALD background were also associated with increased use of some hospital services. There was no association between lower scores on any HLQ scale and greater use of hospital services.ConclusionWe found no association between lower health literacy and greater use of hospital health services. However increased age, having a CALD background and not speaking English at home were all associated with having the most health literacy challenges Strategies to address these are needed to reduce health inequalities.

Highlights

Health literacy is defined as an individual’s ability to access, understand and use information in ways that promote and maintain good health
We identified a range of potentially modifiable health literacy needs in hospitalised patients
Unlike the prevailing literature [26,27,28], we did not find being from a culturally and linguistically diverse (CALD) background was associated with increased use of hospital services – we found that people from a CALD background were more likely to report less attendances at any Emergency department (ED) over the last 12 month months

Summary

Introduction

Health literacy is defined as an individual’s ability to access, understand and use information in ways that promote and maintain good health. An ongoing challenge for hospitals is the management of potentially avoidable hospitalisations for conditions that may have been treated or managed out of hospital [11]. Health literacy is defined by the World Health Organisation as ‘the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health’ [12]. Individuals require good health literacy in order to access and understand all the information and support they require to appropriately manage unexpected acute illness or existing chronic conditions [13, 14]

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