Health literacy and outcomes among patients with heart failure.
Health literacy and outcomes among patients with heart failure.
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DOI：
10.1001/jama.2011.512
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发表时间：
2011-04-27
期刊：
影响因子：
--
通讯作者：
Masoudi FA
中科院分区：
文献类型：
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作者：
Peterson PN;Shetterly SM;Clarke CL;Bekelman DB;Chan PS;Allen LA;Matlock DD;Magid DJ;Masoudi FA
人们对心力衰竭（HF）患者健康素养低下的影响知之甚少，心力衰竭（HF）患者需要自我管理并与医疗保健系统频繁互动。评估心力衰竭门诊患者健康素养低下与全因再住院和死亡率之间的关联。科罗拉多州 Kaiser Permanente 是一家综合管理式医疗机构，进行了回顾性队列研究。 2001 年 1 月至 2008 年 5 月期间发现心力衰竭患者，并进行平均 1.2 年的随访。对患者进行了调查。使用三个既定的筛查问题对健康素养进行评估，并将其分为“足够”或“低”。心力衰竭门诊患者。全因死亡率和住院治疗。调查回复率为72%。 1494 名患者中，262 名（17.5%）的健康素养较低。健康素养较低的患者年龄较大，社会经济地位较低，至少受过高中教育的可能性较小，并且共存疾病的比例较高。在多变量 Cox 回归中，低健康素养与较高死亡率独立相关（未经调整的 17.6% vs. 6.3%；调整后的风险比 [HR]：1.61；95% CI 1.06–2.43；p=0.026），但与住院率无关（30.5% vs. 23.2%；HR：1.04；95% CI 0.79–1.37；p=0.026）。 p=0.760）。在综合管理医疗组织中的心力衰竭患者中，健康素养较低与全因死亡率较高显着相关。
Little is known about the impact of low health literacy among patients with heart failure (HF), a condition that requires self-management and frequent interactions with the healthcare system. Evaluate the association between low health literacy and all-cause rehospitalization and mortality among outpatients with HF. Retrospective cohort study performed at Kaiser Permanente Colorado, an integrated managed care organization. Patients with HF were identified between Jan, 2001 and May, 2008 and followed for a mean of 1.2 years. Patients were surveyed. Health literacy was assessed using three established screening questions and categorized as adequate or low. Outpatients with HF. All-cause mortality and hospitalization. The survey response rate was 72%. Of 1494 patients, 262 (17.5%) had low health literacy. Patients with low health literacy were older, of lower socioeconomic status, less likely to have at least a high school education and had higher rates of coexisting illnesses. In multivariable Cox regression, low health literacy was independently associated with higher mortality (unadjusted 17.6% vs. 6.3%; adjusted hazard ratio [HR]: 1.61; 95% CI 1.06–2.43; p=0.026), but not hospitalization (30.5% vs. 23.2%; HR:1.04; 95% CI 0.79–1.37; p=0.760). Among patients with HF in an integrated managed care organization, low health literacy was significantly associated with higher all-cause mortality.