Potentially Preventable Use of Emergency Services

Abstract

Background Limited health literacy is a barrier to understanding health information and has been identified as a risk factor for overuse of the emergency department (ED). The association of health literacy with access to primary care services in patients presenting to the ED has not been fully explored. Objective To examine the relationship between health literacy, access to primary care and reasons for ED use among adults presenting for emergency care. Methods Structured interviews that included health literacy assessment were performed with 492 ED patients at one Southern academic medical center. Unadjusted and multivariable logistic regression models assessed the relationship between health literacy and 1) access to a personal physician, 2) doctor office visits, 3) ED visits, 4) hospitalizations, and 5) potentially preventable hospital admissions. Results After adjusting for sociodemographic and health status, those with limited health literacy reported fewer doctor office visits (OR=0.6, 95% CI=0.4-1.0), greater ED use (OR=1.6, 95% CI 1.0-2.4) and had more potentially preventable hospital admissions (OR=1.7, 95% CI=1.0-2.7) than those with adequate health literacy. After further controlling for insurance and employment status, fewer doctor office visits remained significantly associated with patient health literacy. (OR=0.5, 95% CI=0.3-0.9). Patients with limited health literacy reported a preference for emergency care, as the services were perceived as better. Conclusions Among ED patients, limited health literacy was independently associated with fewer doctor office visits and a preference for emergency care. Policies to reduce ED use should consider steps to limit barriers and improve attitudes towards primary care services.

Association of Health Literacy With Elevated Blood Pressure

“…28,29 Baker and colleagues demonstrated a relationship of health literacy with cardiovascular mortality. 30 Schumacher and colleagues 31 found that patients with low health literacy had fewer doctor office visits (OR 0.6, 95% CI 0.4–1.0), greater emergency department use, OR 1.6; 95% CI, 1.0–2.4), and had more potentially preventable hospital admissions (OR 1.7; 95% CI, 1.0–2.7) than those with adequate health literacy.…”

Emergency Department utilization among Deaf American Sign Language users

“…1 Higher rates of inappropriate ED utilization can lead to a variety of poorer health outcomes such as decreased preventive care services receipts, increased inpatient hospitalizations, lower satisfaction with health care, and higher health care costs. 2,3 National data show that one in five adult Americans (20.1%) utilized emergency room services in the last 12 months with this proportion varying on the basis of age, gender, race, educational achievement, income and status.…”

Toimeentulotuen asiakkaiden terveyspalvelujen käyttö Helsingissä vuonna 2014

“…oikea-aikainen pääsy terveysaseman vastaanotolle, ikä, sosioekonominen asema, ja potilaan työntekijän väli-nen vuorovaikutus (35). Lisäksi lisääntyneeseen päivystyksen käyttöön ovat yhteydessä myös kyky ymmärtää ja tulkita omaa terveyttä koskevaa informaatiota ja tehdä omia elintapoja, terveyttä ja terveyspalvelujen käyttöä koskevia päätöksiä (36). Terveyspalvelujen kehittämiseksi tarvitaan tietoja siitä, miten eri väestöryhmien kyky vastaanottaa, ymmärtää ja tulkita omaa terveyttään koskevia tietoja voidaan ottaa huomioon sekä miten voidaan auttaa eri väestöryhmiä tekemään elintapoja ja terveyspalvelujen käyttöä koskevia päätöksiä.…”