Heart failure outpatients with low health literacy have increased risk of death, not hospitalizations
TUESDAY, April 26 (HealthDay News) -- For outpatients with heart failure, low health literacy is significantly correlated with higher all-cause mortality, according to a study published in the April 27 issue of the Journal of the American Medical Association.
Pamela N. Peterson, M.D., M.S.P.H., from the Denver Health Medical Center, and colleagues assessed the correlation between low health literacy and all-cause mortality and hospitalization among outpatients with heart failure managed in an integrated care organization (Kaiser Permanente Colorado). A total of 2,156 outpatients were identified between 2001 and 2008, and 1,494 eligible responders were followed up for an average of 1.2 years. Health literacy was evaluated using three established screening questions and was categorized as acceptable or low. The main outcome measures were all-cause mortality and all-cause hospitalization.
The investigators found that 262 responders (17.5 percent) had low health literacy; they were also older, of lower socioeconomic status, less likely to have at least a high school education, and had higher rates of comorbidity. Based on multivariable analysis, low health literacy was independently and significantly associated with increased mortality (adjusted hazard ratio, 1.97), but not with hospitalization.
"This study demonstrates that even among those with health insurance and access to health information, low health literacy as assessed by three brief screening questions is associated with higher mortality," the authors write.
Several of the study authors disclosed financial ties to the health care and pharmaceutical industries.
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