Association between health literacy and medical care costs in an integrated healthcare system: a regional population based study.
Association between health literacy and medical care costs in an integrated healthcare system: a regional population based study.
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在综合医疗系统中，健康素养与医疗保健成本之间的关联：基于区域人口的研究。
DOI：
10.1186/s12913-015-0887-z
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发表时间：
2015-06-27
影响因子：
2.8
通讯作者：
Lapcevic WA
中科院分区：
文献类型：
--
作者：
Haun JN;Patel NR;French DD;Campbell RR;Bradham DD;Lapcevic WA
低健康素养与较高的医疗保健利用率和成本相关;然而，在退伍军人健康管理局（VHA）中没有大规模的研究证明这一点。这项研究评估了退伍军人的健康素养与他们随后的VHA医疗保健费用之间的关系，为期三年。这项回顾性研究使用广义线性模型来估计患者的健康素养和VHA医疗费用之间的相对关联，并对协变量进行调整。二级数据源包括VHA中的电子健康记录和行政数据（例如，医学和DCG SAS数据集和DSS-国家数据提取）。卫生知识评估和标识符是从原始卫生系统以电子方式检索的。从VHA集中数据库中检索所有三年内使用VHA的相应患者的人口统计学和成本数据。在2007-2009年对92，749名退伍军人进行的一项研究中，那些健康素养不足和边缘的患者的平均每位患者成本显着更高（31，581美元[95%CI：30，186 - 32，975美元]; 23，508美元[95%CI：22，749 - 24，268美元]）比适当的健康知识普及（17，033美元[95%CI：16，810 - 17，255美元]）。估计与退伍军人的边缘和不充分的健康知识相关的三年成本比那些有足够的健康知识的人多1.43亿美元。分析表明，当控制VHA综合医疗保健系统内的其他人的层面的因素，较低的健康素养是一个重要的独立因素与增加医疗保健利用率和成本。这项研究证实了较低的健康素养与较高的医疗服务利用率和药房费用的退伍军人在VHA注册的关联。确认与较低的健康知识相关的较高的护理成本表明，干预措施可能旨在补救健康知识的需求和减少支出。这些分析表明，该人群中17.2%（不充分且微不足道）的退伍军人占这三年期间退伍军人管理局医疗和药房成本的近四分之一（24%）。满足那些边缘和不充分的健康知识的需求可以为这一人群节省大约8%的总成本。
Low health literacy is associated with higher health care utilization and costs; however, no large-scale studies have demonstrated this in the Veterans Health Administration (VHA). This research evaluated the association between veterans’ health literacy and their subsequent VHA health care costs across a three-year period. This retrospective study used a Generalized Linear Model to estimate the relative association between a patient’s health literacy and VHA medical costs, adjusting for covariates. Secondary data sources included electronic health records and administrative data in the VHA (e.g., Medical and DCG SAS Datasets and DSS-National Data Extracts). Health literacy assessments and identifiers were electronically retrieved from the originating health system. Demographic and cost data were retrieved from the VHA centralized databases for the corresponding patients who had VHA use in all three years. In a study of 92,749 veterans with service utilization from 2007–2009, average per patient cost for those with inadequate and marginal health literacy was significantly higher ($31,581 [95 % CI: $30,186 - $32,975]; $23,508 [95 % CI: $22,749 - $24,268]) than adequate health literacy ($17,033 [95 % CI: $16,810 - $17,255]). Estimated three-year cost associated with veterans’ with marginal and inadequate health literacy was $143 million dollars more than those with adequate health literacy. Analyses suggest when controlling for other person-level factors within the VHA integrated healthcare system, lower health literacy is a significant independent factor associated with increased health care utilization and costs. This study confirms the association of lower health literacy with higher medical service utilization and pharmacy costs for veterans enrolled in the VHA. Confirmation of higher costs of care associated with lower health literacy suggests that interventions might be designed to remediate health literacy needs and reduce expenditures. These analyses suggest 17.2 % (inadequate & marginal) of the Veterans in this population account for almost one-quarter (24 %) of VA medical and pharmacy cost for this 3-year period. Meeting the needs of those with marginal and inadequate health literacy could produce potential economic savings of approximately 8 % of total costs for this population.
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影响因子：
5.7
作者：
Sudore, Rebecca L.;Yaffe, Kristine;Schillinger, Dean
通讯作者：
Schillinger, Dean
DOI：
10.1111/j.1532-5415.2006.00691.x
发表时间：
2006-05-01
影响因子：
6.3
作者：
Sudore, Rebecca L.;Mehta, Kala M.;Yaffe, Kristine
通讯作者：
Yaffe, Kristine
影响因子：
5.9
作者：
Howard, DH;Gazmararian, J;Parker, RM
通讯作者：
Parker, RM
DOI：
10.2307/3349613
发表时间：
1973-01-01
期刊：
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY
影响因子：
--
作者：
ANDERSEN, R;NEWMAN, JF
通讯作者：
NEWMAN, JF
DOI：
10.1186/1478-7547-11-13
发表时间：
2013
期刊：
Cost effectiveness and resource allocation : C/E
影响因子：
--
作者：
Darnell K;Dwivedi AK;Weng Z;Panos RJ
通讯作者：
Panos RJ