Gender differences in the impact of health literacy on hospital readmission among older heart failure patients: A prospective cohort study

Abstract

Aims:To investigate the impact of limited health literacy on 1-year hospital readmission among both older men and women with heart failure.Design: Prospective cohort study. Methods:A total of 286 patients with heart failure (men = 144, women = 142) aged 65 years or older at baseline from two tertiary hospitals were enrolled from June-November 2017. Patients were followed up until November 2018. The Brief Health Literacy Screening Tool was used to assess baseline health literacy. One-year readmission after discharge was assessed via medical records or telephone interview. A hierarchical logistic regression was performed. Results:The prevalence rates of limited health literacy and 1-year hospital readmission among older women were 74.7% and 35.9%, respectively, compared with 48.6% and 27.1% in older men. Limited health literacy significantly increased the risk of 1-year hospital readmission in both older men and women with heart failure. More importantly, older women with limited health literacy had a much higher risk of hospital readmission (odds ratio: 10.17, 95% confidence interval: 2.19-47.14) than did older men with limited health literacy (odds ratio: 5.27, 95% confidence interval: 2.04-13.59). Conclusions:Our findings highlight that a baseline assessment of health literacy would help prevent unplanned hospital readmissions after discharge in both older men and women with heart failure. Health professionals should recognize that women with limited health literacy are more vulnerable to re-hospitalization than are men with limited health literacy.Impact: Few studies have addressed gender differences in the link between health literacy and hospital readmission among patients with heart failure. We found that older women with limited health literacy had a much higher risk of hospital readmission than did their male counterparts. Health professionals should be aware of gender differences in health literacy in discharge planning, including self-management counselling for older patients with heart failure. K E Y W O R D Saged, health literacy, heart failure, nursing, patient readmission

Differentials and predictors of hospitalization among the elderly people in India: Evidence from 75thround of National Sample Survey (2017-18)

“…Our study confirmed that the elderly living in urban residence and elderly males have shown higher hospitalization rate where these findings were consistent with previous research 11,17,[32][33][34][35]38 . Our results revealed that elderly women have lower odds of hospitalization than the elderly men and similar patterns of hospitalizations were also observed in other countries like-England 39 , Norway 17,40 , Italy 41 , but countries like Denmark 42 , Finnland 40 , South Korea 43 and Brazil 44 have shown higher hospitalization among older women than older men. Interestingly, our study have showed that married elderly was found to be less likely to be hospitalized than unmarried, these finding are analogous to the other previous studies 11,35,[45][46][47][48] .…”

Scoping review: Influence of cisgender male and female genders on health literacy of the elderly people

“…The expression of HL as capabilities and competencies of the elderly people in the included articles additionally showed that based on the social status within a patriarchal society men were more likely to be able to access HL information and engage in HL activities (Parmar et al., 2014); that sex (gender) could not be a predictor of mental HL (Piper et al., 2018); and that while women may have higher levels of HL than men they are more susceptible to diabetes and that men with lower HL levels were more likely to have diabetes than men with higher HL levels (Quartuccio et al., 2018). Also, the included articles showed that in a predominantly female sample HL was measured by mental cognition (Serper et al., 2014); and that low HL was more common among women but low HL among women was associated with the advancement of age whereas low HL among men was associated with lower education levels (Son & Won, 2020).…”

“…Social class may also affect the application of HL (Thompson et al., 2017). In general, male and female genders have an influence on the self‐health management of the elderly people in terms of the level of pain or disease severity (Gwynn et al., 2016; Lei et al., 2014; MacLeod et al., 2017; Quartuccio et al., 2018; Son & Won, 2020; Verney et al., 2019).…”

“…As a gender, men were reported to have lower HL levels (although this may be mitigated by other sociocultural and socioeconomic factors) than women (Fleisher et al., 2016; Fonesca et al., 2015; Lei et al., 2014; MacLeod et al., 2017; Thompson et al., 2017; Verney et al., 2019). Men may have more opportunities to be made aware of HL and SHPs, indicative that gender may afford men more HL opportunities (Parmar et al., 2014) but lower education levels would inversely affect the acknowledgement of HL information (Son & Won, 2020).…”

Health Literacy in Patients’ Clinical Records of Hospital Settings: A Systematic Review

“…However, these results might depend on different factors. First, it was often unclear whether HL was assessed as part of clinical research or integrated into the patients’ clinical records ( Son & Won, 2020 ). Hence, these studies were not considered.…”