Abstract
Introduction:Patients with low health literacy (HL) and minority patients encounter many challenges during hospital to community transitions. We assessed care transitions of minority patients with various HL levels and tested whether presence of caregivers and provision of language-concordant care are associated with better care transitions.Methods:A prospective cohort study of 598 internal medicine patients, Hebrew, Russian, or Arabic native speakers, at a tertiary medical center in central Israel, from 2013 to 2014.HL was assessed at baseline with the Brief Health Literacy Screen. A follow-up telephone survey was used to administer the Care Transition Measure [CTM] and to assess, caregiver presence and patient–provider language-concordance at discharge.Results:Patients with low HL and without language-concordance or caregiver presence had the lowest CTM scores (33.1, range 0–100). When language-concordance and caregivers were available, CTM scores did not differ between the medium-high and low HL groups (68.7 and 66.9, respectively, p = 0.118). The adjusted analysis, showed that language-concordance and caregiver presence during discharge moderate the relationship between HL and patients’ care transition experience (p < 0.001).Conclusions:Language-concordance care and caregiver presence are associated with higher patients’ ratings of the transitional-care experience among patients with low HL levels and among minorities.
Highlights
Patients with low health literacy (HL) and minority patients encounter many challenges during hospital to community transitions
Previous research did not examine whether the receipt of discharge explanations in the patient’s native language and the presence of caregivers during the discharge briefing is associated with a better transitional care experience of minorities and low HL patients
Associated with patients’ ratings of their care transitions, and (2) provisions of care during discharge moderates the relationship between HL and patients’ care transition experience. These findings show that the negative impact of low HL is potentially mitigated when languageconcordance and caregiver presence are available during discharge
Summary
Patients with low health literacy (HL) and minority patients encounter many challenges during hospital to community transitions. Previous research did not examine whether the receipt of discharge explanations in the patient’s native language and the presence of caregivers during the discharge briefing is associated with a better transitional care experience of minorities and low HL patients. To fill this gap, we examined hospital to home transitions of internal medicine minority patients, including members of the Arabic speaking population (mostly Muslims from villages in the central area of Israel) and self-identified Russian native speakers (of immigrants from the former Soviet Union who immigrated to Israel mainly from the 1990s onward) and the general (Hebrew speaking) Israeli population. We examined whether provision of language-concordant care and presence of caregivers during discharge moderate the relationship between HL and patients’ assessment of their care transitions
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