MP31-15 IMPACT OF HEALTH LITERACY ON DISCHARGE DISPOSITION FOLLOWING RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making III1 Apr 2016MP31-15 IMPACT OF HEALTH LITERACY ON DISCHARGE DISPOSITION FOLLOWING RADICAL CYSTECTOMY Stephen F. Kappa, Kristen R. Scarpato, Kathryn M. Goggins, Sam S. Chang, Joseph A. Smith, Peter E. Clark, David F. Penson, Matthew J. Resnick, Daniel A. Barocas, Sunil Kripalani, and Kelvin A. Moses Stephen F. KappaStephen F. Kappa More articles by this author , Kristen R. ScarpatoKristen R. Scarpato More articles by this author , Kathryn M. GogginsKathryn M. Goggins More articles by this author , Sam S. ChangSam S. Chang More articles by this author , Joseph A. SmithJoseph A. Smith More articles by this author , Peter E. ClarkPeter E. Clark More articles by this author , David F. PensonDavid F. Penson More articles by this author , Matthew J. ResnickMatthew J. Resnick More articles by this author , Daniel A. BarocasDaniel A. Barocas More articles by this author , Sunil KripalaniSunil Kripalani More articles by this author , and Kelvin A. MosesKelvin A. Moses More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1268AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Health literacy is the ability to obtain, comprehend and act on medical information, and is an independent predictor of health outcomes in patients with chronic health conditions. There are few data regarding health literacy and its relationship to discharge disposition. We hypothesized that patient discharge needs after radical cystectomy (RC) are affected by health literacy status, and that patients with lower health literacy were more likely to utilize home health care, skilled nursing facility, or other rehabilitation resources in the immediate post-operative period. METHODS Since November 2010, all patients admitted to Vanderbilt University Medical Center are administered the validated Brief Health Literacy Screen (BHLS). We analyzed an IRB-approved, prospectively managed database and identified 504 patients who underwent RC and had available health literacy data. Patient characteristics as well as discharge disposition (home, home health care, skilled nursing facility, or other rehabilitation resources) were recorded. We performed bivariate and logistic regression analysis adjusted for clinical and demographic characteristics to determine if health literacy was associated with the utilization of post-discharge services after RC. RESULTS More than half of all patients undergoing RC required post-discharge services. Compared to patients with high health literacy, patients with lower health literacy were more likely to utilize post-discharge services (55.6% vs. 45.6%, p<0.05). On multivariate analysis, health literacy was not associated with the use of post-discharge services (OR = 0.9, CI: 0.8-1.0, p=0.09). Older age (OR = 1.1, CI: 1.0-1.1, p<0.001) and higher Charlson Comorbidity Index (OR = 1.1, CI: 1.0-1.2, p<0.05) were associated with the use of post-discharge services, while patients with continent diversions (neobladder, Indiana pouch) were less likely to require post-discharge services than patients with an ileal conduit (OR 0.4, CI: 0.2-0.8, p<0.01). CONCLUSIONS Older age, comorbidities, and incontinent urinary diversions are associated with increased utilization of post-discharge services after RC. Lower health literacy may affect patient discharge disposition, but was not significant on multivariate analysis. This finding may reflect an unmet need for patients with lower health literacy given the complex self-care required of patients after cystectomy. Further studies are needed to determine the associations between health literacy, discharge disposition, and other surgical outcomes. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e425 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Stephen F. Kappa More articles by this author Kristen R. Scarpato More articles by this author Kathryn M. Goggins More articles by this author Sam S. Chang More articles by this author Joseph A. Smith More articles by this author Peter E. Clark More articles by this author David F. Penson More articles by this author Matthew J. Resnick More articles by this author Daniel A. Barocas More articles by this author Sunil Kripalani More articles by this author Kelvin A. Moses More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...