The influence of health literacy on emergency department utilization and hospitalizations in adolescents with sickle cell disease

Abstract

Objective Healthcare spending in the US is $3.2 trillion. $1.1 trillion is attributed to hospital care, including emergency department (ED) visits and hospitalizations. There is a relationship between ED utilization, hospitalizations, and health literacy in the general population. Health literacy may play a role in frequent ED visits and hospitalizations in patients with sickle cell disease (SCD). The purpose of this paper is to describe the relationship among health literacy levels, annual hospital encounters, annual clinic visits, annual ED visits, and annual hospitalizations in 134 Black, non‐Hispanic adolescents aged 10–19 years with SCD. Design This is a cross‐sectional, descriptive correlational study evaluating facilitators and barriers to health literacy and clinical outcomes in adolescents with SCD. Sample Data were collected from 134 Black, non‐Hispanic adolescents with SCD at a large, tertiary care center in Texas. Measurements The Newest Vital Sign and REALM‐Teen health literacy instruments were used to evaluate health literacy. Results Contrasting previous studies evaluating the influence of health literacy on ED visits and hospitalizations in the general population, there were no significant relationships within this sample. Conclusions This study gives insight into future research to evaluate other potential influences on ED utilization and hospitalizations in pediatric patients with SCD.

Is subjectively perceived treatment urgency of patients in emergency departments associated with self-reported health literacy and the willingness to use the GP as coordinator of treatment? Results from the multicentre, cross-sectional, observational study PiNo Bund

“…40 Another recent study from the USA also found no relationship between health literacy and emergency department utilisation. 41 We did not find an association between having a regular GP and the self-reported treatment urgency, but the willingness to use the GP as coordinator of treatment predicted a higher subjective treatment urgency. The subjectively perceived lack of availability of primary care is a frequently mentioned reason for attending emergency departments with conditions of low treatment urgency.…”

The health literacy disparity in adolescents with sickle cell disease

“…Additionally, adolescents with SCD demonstrated a vast gap in numeracy, the ability to understand math and perform simple math functions (Caldwell et al, 2018). Furthermore, adolescents with SCD demonstrated limited overall health literacy, a troublesome trend for any adolescents, especially those with chronic illness (Caldwell et al, 2018;Caldwell, 2019;Perry et al, 2017). Our current findings demonstrate similar troublesome findings in this sample of adolescents with SCD.…”

“…A few previous studies have evaluated health literacy of adolescents with SCD, leading to worrisome results. When given standard health literacy evaluations, adolescents with SCD performed at a level below that of both their age and grade levels (Caldwell, 2019;Perry et al, 2017). Additionally, adolescents with SCD demonstrated a vast gap in numeracy, the ability to understand math and perform simple math functions (Caldwell et al, 2018).…”

“…It has recently been postulated that these difficulties during transition could be influenced by health literacy (Caldwell, 2019(Caldwell, , 2020Perry et al, 2017). Health literacy is defined as "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" (Ratzan & Parker, 2000).…”

The Montreal cognitive assessment as a cognitive screening tool in sickle cell disease: Associations with clinically significant cognitive domains

“…In the general population, low literacy and health literacy are linked to poor adherence to health-promoting behaviours, such as attending clinic visits, or taking medications as prescribed. [14][15][16][17] While studies are limited in SCD, there are interventions that have been shown to improve health literacy in other chronically ill patients. 13,14 In SCD, improved literacy predicts successful transition to adult care.…”