TY - JOUR
T1 - Assessing patient activation and health literacy in the ED
AU - Sheikh, Sophia
AU - Hendry, Phyllis
AU - Kalynych, Colleen
AU - Owensby, Brittany
AU - Johnson, Jennifer
AU - Kraemer, Dale F.
AU - Carden, Donna
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background Low health literacy and patient activation are linked to unmet health needs, excess emergency department (ED) use, and hospital admission. However, most studies have assessed these measures in non-ED populations. Objective The objective of the study is to assess health literacy and patient activation in the ED. Methods A cross-sectional study in adults older than 18 years presenting to an ED were selected using systematic sampling. Demographic data and reason for ED visit were collected. Health literacy was assessed using Rapid Estimate of Adult Literacy in Medicine (REALM). Patient activation was assessed using Patient Activation Measure. Kruskal-Wallis tests compared groups. Spearman rank correlations compared numeric variables. Results A total of 140 patients were approached, and 108 enrolled. Average age was 51 years. Most were unemployed (71%), were unmarried (80%), had a primary physician (62%), were male (60%), were African American (63%), and were on public insurance (58%). Most had an activation level of 3 or 4. The mean REALM score was 52. Patients with higher REALM scores had higher activation levels (rs = 0.30; P =.0017), although, when adjusted for age, this association was no longer significant. Sex, education, insurance status, and race were not significantly associated with REALM or activation levels. Activation levels decreased with increasing age (rs = - 0.24; P =.01). Low activation levels and limited health literacy were significantly associated with admission (odds ratio, 4.4; 95% confidence interval, 1.5-12.6; P =.0061). Conclusions This is the first study to assess Patient Activation Measure in the ED. Low activation levels and limited REALM scores assessed in the ED population were significantly associated with hospital admission. Assessing activation levels of ED patients could lead to better education and tailored discharge planning by ED clinicians potentially reducing ED revisits.
AB - Background Low health literacy and patient activation are linked to unmet health needs, excess emergency department (ED) use, and hospital admission. However, most studies have assessed these measures in non-ED populations. Objective The objective of the study is to assess health literacy and patient activation in the ED. Methods A cross-sectional study in adults older than 18 years presenting to an ED were selected using systematic sampling. Demographic data and reason for ED visit were collected. Health literacy was assessed using Rapid Estimate of Adult Literacy in Medicine (REALM). Patient activation was assessed using Patient Activation Measure. Kruskal-Wallis tests compared groups. Spearman rank correlations compared numeric variables. Results A total of 140 patients were approached, and 108 enrolled. Average age was 51 years. Most were unemployed (71%), were unmarried (80%), had a primary physician (62%), were male (60%), were African American (63%), and were on public insurance (58%). Most had an activation level of 3 or 4. The mean REALM score was 52. Patients with higher REALM scores had higher activation levels (rs = 0.30; P =.0017), although, when adjusted for age, this association was no longer significant. Sex, education, insurance status, and race were not significantly associated with REALM or activation levels. Activation levels decreased with increasing age (rs = - 0.24; P =.01). Low activation levels and limited health literacy were significantly associated with admission (odds ratio, 4.4; 95% confidence interval, 1.5-12.6; P =.0061). Conclusions This is the first study to assess Patient Activation Measure in the ED. Low activation levels and limited REALM scores assessed in the ED population were significantly associated with hospital admission. Assessing activation levels of ED patients could lead to better education and tailored discharge planning by ED clinicians potentially reducing ED revisits.
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U2 - 10.1016/j.ajem.2015.09.045
DO - 10.1016/j.ajem.2015.09.045
M3 - Article
C2 - 26508580
AN - SCOPUS:84952995768
SN - 0735-6757
VL - 34
SP - 93
EP - 96
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 1
ER -