Monday, July 14, 2008

Health literacy and the emergency room

A multicenter, cross-sectional study in last month's Academic Emergency Medicine administered a short health literacy assessment questionnaire to 300 patients in 3 Boston emergency rooms. In addition to examining raw scores, investigators also looked at correlations with other sociodemographic variables.

Older age, less education, and lower income were all associated with reduced functional health literacy. Associations with ethnicity, race, and language were not statistically significant in the multivariate analysis (i.e. after correcting for other variables).

The authors note "In this sample, one-quarter of ED patients would be expected to have difficulty understanding health materials and following prescribed treatment regimens. Advanced age and low socioeconomic status were independently associated with limited health literacy. The ability of a significant subgroup of ED patients to understand health information, especially during illness or injury, requires further study."

One potential limitation that comes to mind - a cross-sectional study gives just a snapshot, rather than a longitudinal assessment -- the questionnaire results reflect each individual's completion of a brief test during their stay in the ED setting, which is a fairly difficult environment given the complexity of this kind of healthcare encounter (stress of the health condition, urgency, family issues, financial considerations, etc.). The competing concerns of the environment may shift individual test results downward. If you tested the same person while they were going to a routine visit at their doctor, their results may be different.

On the other hand, the methods of the current study would seem to give an accurate picture of functional health literacy at the moment of crisis, which speaks more to how people may (or may not) be able to handle, process, and retain information in that particular setting.

So, having a librarian stationed in the ED might not, then, be a good idea, but do other strategies come to mind for aiding individuals with lower health literacy in this setting?

Reference: Ginde AA, Weiner SG, Pallin DJ, Camargo CA Jr. Multicenter study of limited health literacy in emergency department patients. Acad Emerg Med. 2008 Jun;15(6):577-80. PubMed abstract

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Blogger K said...

Thanks for the information on emergency medicine. Those facts are very sad...

We recently wrote an article on emergency rooms at Brain Blogger. With emergency rooms being so overcrowded and understaffed, who's to blame for when patients die? What if they die while waiting? Is there anyone to blame for that?

We would like to read your comments on our article. Thank you.


8/01/2008 3:40 PM  

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