The influence of health literacy on readmission to acute hospital amongst adults

Abstract

Overview of the topic: Health literacy refers to the individual’s ability to obtain, process and understand health information that is needed to take the appropriate decision (Sorensen et al., 2012). It is understood that the complexity of the health care system increases the need of shared responsibility and self-management between staff and service users. This understanding highlights the importance of patient participation in one’s own care (Walker & Barnett, 2007). In turn, health care professionals play an important role in teaching and delivering an adequate level of Health Literacy (Dewalt et al., 2014). The degree of Health Literacy of an individual has been associated with both positive and negative outcomes. A significant body of evidence shows that low health literacy levels are associated with poor health and negative outcomes (Walker & Barnett, 2007). The research exercise reported in this dissertation sought to look at whether the patient’s level of health literacy influences hospital readmission. Research question: Among hospital discharged adult patients, does the level of Health Literacy influence the probability of readmission to an acute hospital? PEO elements: The population (P); discharge adults. The Exposure (E); level of health literacy, Outcome (O); hospital readmission. Method: The PEO elements were used to generate alternative terms which were then combined using the Boolean Operators. The search was carried out using different databases including; Hydi, EBSCO, PubMed, Science Direct and Scopus. Also, the author looked at the reference lists in some articles and at unpublished research studies carried out at the University of Malta. A set of inclusion and exclusion criteria were used to assess the eligibility of the selected articles. Further exclusion of irrelevant articles was done using The PRISMA 2009 checklist. All the articles were critically appraised using Critical Appraisal Skills Programme (CASP) tools. Results: A total of twelve studies were identified. These included; three Randomized Control Trials, two Cross Section and seven Cohort studies. Eleven out of the twelve research studies established an association between the level of the Health Literacy of an individual and Hospital Readmission. Conclusion: The evidence in the literature suggests an association between a patient’s level of Health Literacy and Hospital Readmission. Furthermore, studies showed that individuals with low level of Health Literacy have a higher risk of poor understanding of one’s own health, a poorer health status, and an increased risk of early mortality and higher expenditure on health services. Implications and recommendations: The introduction of Health Literacy screening tools as part of regular profession practice and care planning across the health care system is recommended. This will increase the chance of having professionals to adopt the needed interventions to address health literacy, as well as enabling better health outcomes. In addition, professionals should hold the necessary skills for effective communication with service users including the use of creative interventions for communication. Future studies may focus on Health Literacy in multicultural populations, and also the association between Health Literacy and social determinants of health.