A study based on the Health Literacy Questionnaire (HLQ) has been published in the BMC Health Services Research series.
Health literacy is simply defined as an individual’s ability to access, understand and use information in ways that promote and maintain good health.
Lower health literacy has been found to be associated with increased emergency department presentations and potentially avoidable hospitalisations.
The study aimed to determine the health literacy of hospital inpatients, and to examine if associations exist between different dimensions of their health literacy, sociodemographic characteristics and hospital services use.
A written survey was sent to 3,252 people aged over 18 years in English, Arabic, Chinese, Vietnamese, Italian or Greek. The survey included demographic and health questions, and the Health Literacy Questionnaire (HLQ).
The HLQ is a multidimensional instrument comprising nine independent scales. Use of hospital services was measured by length of stay, number of admissions in 12 months and number of emergency department presentations.
385 questionnaires were returned. Participants had a mean age 64 years, 49% were female.
Being aged over 65 years, using the Internet less than once a month, failure to complete high school, low household income, receiving means-tested government benefits (61%) and being from a culturally and linguistically diverse (CALD) background, were all associated with lower scores in some health literacy scales.
Being aged over 65 years, not currently employed, receiving government benefits, and being from a CALD background were also associated with increased use of some hospital services.
There was no association between lower scores on any HLQ scale and greater use of hospital services.
The authors conclude that the study has provided new insights into the complexity of health literacy, including not only an individual’s skills in terms of finding, understanding and using health-related information but also their ability to navigate the health system and engage with health professionals, and their social supports.
The HLQ embraces the full concept of health literacy by encompassing measurement of both a set of different individual skills and the lived experience of a person interacting with the services, systems and environment. These need to be considered together.
For example, the study found that increased age was associated with greater difficulty in finding health information, but older individuals were also more likely to report greater healthcare provider and social support than those under age 65 years. This suggests that social and health professional supports can offset other health literacy difficulties, while lack of these supports might indicate a need to provide additional assistance and resources.
You can read the full paper here.
Health literacy of recently hospitalised patients: a cross-sectional survey using the Health Literacy Questionnaire (HLQ)
Jessup et al. BMC Health Services Research (2017) 17:52