Higher Mortality
Low health literacy is significantly associated with higher mortality in patients with heart failure. This is the conclusion drawn by researchers who designed a retrospective study of patients at Kaiser Permanente in Colorado.
They examined cases of heart failure from 2001 to 2008, surveying patients by mail. The patients were also followed for a median of 1.2 years. Health literacy was assessed using well-established screening questions and categorized as either “adequate” or “low”. Then researchers looked at hospitalization and mortality for all causes.
The survey response rate was 72% (1547 of 2156); 17.5% of responders had low health literacy. Low health literacy was associated with:
- Increased age
- Lower socioeconomic status
- Less likelihood of having at least a high school education
- Higher rates of co-morbidities
In multivariable Cox regression, low health literacy was independently associated with higher mortality (unadjusted rate, 17.6% vs 6.3%; adjusted hazard ratio, 1.97 [95% confidence interval, 1.3-2.97]; P = .001), but not hospitalization (unadjusted rate, 30.5% vs 23.2%; adjusted hazard ratio, 1.05 [95% confidence interval, 0.8-1.37]; P = .73).
This study was published in the Journal of the American Medical Association (JAMA. 2011; 305(16):1695-701 (ISSN: 1538-3598).
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