David W. Baker|Julie A. Gazmararian|Mark Williams|Tracy Scott|Ruth M. Parker|Diane Green|Junling Ren|Jennifer L. Peel
Health literacy and use of outpatient physician services by medicare managed care enrollees
Northwestern University|Emory University|Emory University
determine whether inadequate functional health literacy adversely affects use physician outpatient servicescohort studycommunitynew medicare managed care enrollees age 65 older 4 us cities n 3260we measured functional health literacy using short test functional health literacy adults administrative data used determine time first physician visit total number visits 12 months enrollment time first visit proportion without visit adjusted mean visits year enrollment unrelated health literacy crude multivariate analyses participants inadequate marginal health literacy likely emergency department ed visit adequate health literacy 304 276 218 respectively p 01 p 001 respectively multivariate analysis adjusted relative risk 2 ed visits 144 95 confidence interval 101 202 enrollees marginal health literacy 134 100 179 inadequate health literacy compared participants adequate health literacyinadequate health literacy independently associated mean number visits time first visit suggests inadequate literacy major barrier accessing outpatient health care nevertheless higher rates ed use persons low literacy may caused real perceived barriers using usual source outpatient care