M. Balakrishnan|Jill Boylston Herndon|Jingnan Zhang|Thomas Payton|Jonathan J. Shuster|Donna L. Carden
The Association of Health Literacy With Preventable Emergency Department Visits: A Cross?sectional Study
University of Florida|Pfizer (United States)|University of Florida|University of Florida|University of Florida
policymakers argue emergency department ed visits conditions preventable highquality outpatient care contribute waste healthcare system however access ambulatory care uneven especially vulnerable populations like minorities poor limited health literacy impact limited health literacy ed visits preventable timely highquality ambulatory care unknownthe objective determine association health literacy preventable ed visitswe conducted observational crosssectional study potentially preventable ed visits outcome among adults 18 years old ed serving urban community assessed health literacy predictor structured interviews rapid estimate adult literacy medicine realm recorded age sex race employment payer marital health status number comorbidities structured interviews electronic record review identified potentially preventable ed visits 2 years index ed visit applying agency healthcare research quality technical specifications identify ambulatory care sensitive conditions using ed discharge diagnoses hospital administrative data used poisson regression evaluate number preventable ed visits among patients limited realm 61 versus adequate realm 61 health literacy adjusting covariatesof 1201 participants 709 59 female 370 31 african american mean age 416 years 394 33 limited health literacy 4444 total ed visits 423 95 potentially preventable 260 61 resulted hospital admission 163 39 treat release covariates adjusted patients limited literacy 23 95 confidence interval ci 1731 times number potentially preventable ed visits resulting hospital admission compared individuals adequate health literacy 14 95 ci 1020 times number treatandrelease visits 19 95 ci 1524 times number total preventable ed visitsour results suggest ed may important site deploy universal literacysensitive precautions test literacysensitive interventions goal reducing burden potentially preventable ed visits patients healthcare system