Health literacy and preventive health care use among Medicare enrollees in a managed care organization
Health literacy and preventive health care use among Medicare enrollees in a managed care organization
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DOI：
10.1097/00005650-200205000-00005
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发表时间：
2002-05-01
期刊：
影响因子：
3
通讯作者：
Baker, DW
中科院分区：
文献类型：
--
作者：
Scott, TL;Gazmararian, JA;Baker, DW
背景许多老年人在医疗保险管理的保健计划有低健康素养，这可能会影响使用预防服务。确定在调整其他协变量后，健康素养不足的老年人是否比健康素养充足的人更不可能报告接受流感和肺炎球菌疫苗接种、乳房X线检查和巴氏涂片检查。横断面调查;社区居住登记者的家庭访谈。医疗保险管理式护理在美国四个城市（n = 2722）登记65至79岁。措施成人功能性健康素养的短期测试和自我报告的预防服务使用。在双变量分析中，健康素养不足的人自我报告缺乏预防服务的比例高于健康素养充足的人：从未接种过流感疫苗：29%比19%（P = 0.000）;从未接种过肺炎球菌疫苗：65% vs 54%（P = 0.000）;过去2年内未进行乳房X线检查：24% vs 17%（P = 0.017）;从未进行巴氏涂片检查：10% vs 5%（P = 0.002）。在对人口统计学、完成学业的年数、收入、看医生的次数和健康状况进行调整后，健康素养不足的人更有可能报告他们从未感染过流感（OR，1.4; 95% CI，1.1-1.9）或肺炎球菌疫苗接种（OR，1.3; 95% CI，1.1-1.7），女性接受乳房X线检查（OR，1.5; 95% CI，1.0-2.2）或巴氏涂片检查（OR，1.7; 95% CI 1.0-3.1）的可能性较小。在医疗保险管理的医疗注册者中，健康素养不足与预防性卫生服务的使用率较低独立相关。
BACKGROUND. Many older adults in Medicare managed care programs have low health literacy, and this may affect use of preventive services.OBJECTIVES. To determine whether older adults with inadequate health literacy were less likely to report receiving influenza and pneumococcal vaccinations, mammograms, and Papanicolaou smears than individuals with adequate health literacy after adjusting for other covariates.RESEARCH DESIGN. Cross-sectional survey; home interviews with community dwelling enrollees.SUBJECTS. Medicare managed care enrollees 65 to 79 years old in four US cities (n = 2722). MEASURES. Short Test of Functional Health Literacy in Adults and self-reported preventive service use.RESULTS. In bivariate analyses, self-reported lack of preventive services was higher among individuals with inadequate health literacy than those with adequate health literacy: never had an influenza vaccination: 29% versus 19% (P = 0.000); never had a pneumococcal vaccination: 65% versus 54% (P = 0.000); no mammogram in the last 2 years: 24% versus 17% (P = 0.017); never had a Papanicolaou smear: 10% versus 5% (P = 0.002). After adjusting for demographics, years of school completed, income, number of physician visits, and health status, people with inadequate health literacy were more likely to report they had never received the influenza (OR, 1.4; 95% Cl, 1.1-1.9) or pneumococcal vaccination (OR, 1.3; 95% Cl, 1.1-1.7), and women were less likely to have received a mammogram (OR, 1.5; 95% CI, 1.0-2.2) or Papanicolaou smear (OR, 1.7; 95% CI 1.0-3.1).CONCLUSIONS. Among Medicare managed care enrollees, inadequate health literacy is independently associated with lower use of preventive health services.