Pamela N. Peterson
Health Literacy and Outcomes Among Patients With Heart Failure
University of Colorado Denver|Outcomes Research Consortium|Denver VA Medical Center|University of Missouri–Kansas City|Denver Health Medical Center
little known effects low health literacy among patients heart failure condition requires selfmanagement frequent interactions health care systemto evaluate association low health literacy allcause mortality hospitalization among outpatients heart failureretrospective cohort study conducted kaiser permanente colorado integrated managed care organization outpatients heart failure identified january 2001 may 2008 surveyed mail underwent followup median 12 years health literacy assessed using 3 established screening questions categorized adequate low responders excluded complete least 1 health literacy question least 1 year enrollment prior survey dateallcause mortality allcause hospitalizationof 2156 patients surveyed 1547 responded 72 response rate 1494 included responders 262 175 low health literacy patients low health literacy older lower socioeconomic status less likely least high school education higher rates coexisting illnesses multivariable cox regression low health literacy independently associated higher mortality unadjusted rate 176 vs 63 adjusted hazard ratio 197 95 confidence interval 13297 p 001 hospitalization unadjusted rate 305 vs 232 adjusted hazard ratio 105 95 confidence interval 08137 p 73among patients heart failure integrated managed care organization low health literacy significantly associated higher allcause mortality