Objective
We examined the association between caregiver health literacy and the likelihood of a non-urgent emergency department (ED) visit in children presenting for fever.
Methods
This cross-sectional study used the Newest Vital Sign to assess the health literacy of caregivers accompanying children with fever to the ED. Visit urgency was determined by resources utilized during the ED visit. Findings were stratified by race and child age. Chi-square and logistic regression analysis controlling for race were conducted to determine the association between low health literacy and ED visit urgency.
Results
299 caregivers completed study materials. 39% of ED visits for fever were non-urgent and 63% of caregivers had low health literacy. Low health literacy was associated with a higher proportion of non-urgent ED visits for fever (44% vs. 31%, OR 1.8, 95% CI 1.1, 2.9). Low health literacy was associated with higher odds of a non-urgent visit in white and Hispanic caregivers, but not black caregivers. In regression analysis, children ≥ 2 years old had higher odds of a non-urgent visit if caregivers had low health literacy (aOR 2.0; 95% CI 1.1, 4.1); this relationship did not hold for children < 2 years (aOR 0.8; 95% CI 0.4, 1.8).
Conclusions
Nearly two-thirds of caregivers with their child in the ED for fever have low health literacy. Caregiver low health literacy is associated with non-urgent ED utilization for fever in children over 2 years of age. Future interventions could target health literacy skills regarding fever in caregivers of children ≥ 2 years.