Caregiver health literacy and the use of child health services
Caregiver health literacy and the use of child health services
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DOI：
10.1542/peds.2005-1738
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发表时间：
2007-01-01
期刊：
影响因子：
8
通讯作者：
Wilkinson, James D.
中科院分区：
文献类型：
--
作者：
Sanders, Lee M.;Thompson, Valerie T.;Wilkinson, James D.
目标. 8000万美国成年人的健康素养较低，这是成年人使用医疗保健增加的一个风险因素。这项工作的目的是评估照顾者的健康素养和儿童健康服务的使用和成本之间的关联。我们进行了一项横断面研究，从12个月至12岁的儿童样本，提出了一个城市，公立医院的儿科急诊科的两个孩子的二人组。护理人员的健康素养是衡量功能性健康素养的短期测试在他们的首选语言（英语或西班牙语）。通过对公立医院系统的电子数据库和4种类型的就诊（预防性护理、紧急护理、紧急护理和医院护理）的州医疗补助账单记录进行12个月的回顾性审查，来衡量儿童医疗保健的使用情况。儿童医疗保健使用的费用由医疗补助账单记录提供。多变量分析包括照顾者的教育、年龄和语言能力，以及儿童年龄、特殊医疗保健需求、种族和医疗保险覆盖范围。共有290对夫妇入组本研究。22%的护理人员的健康知识水平较低（不足或边缘）。健康素养低的护理人员更有可能接受不到高中教育，英语水平有限，并且出生在美国以外。健康知识水平低的照顾者的子女和健康知识水平高的照顾者的子女在医疗保健使用或费用方面没有差异。三个照顾者特征与儿童卫生保健服务的使用增加相关：出生在美国境外，儿童出生时年龄< 24岁，英语水平有限。五分之一的幼儿照顾者的健康素养低。然而，照顾者的健康素养，是不相关的差异，在使用儿童保健服务，在这个内城，少数民族人口。
OBJECTIVES. Eighty million US adults have low health literacy, a risk factor for increased health care use among adults. The purpose of this work was to assess the association between caregiver health literacy and the use and cost of child health services.METHODS. We conducted a cross-sectional study of caregiver-child dyads from a sample of children aged 12 months to 12 years presenting to the pediatric emergency department of an urban, public hospital. Caregiver health literacy was measured by the Short Test of Functional Health Literacy in their preferred language (English or Spanish). Child health care use was measured by a 12-month retrospective review of the public hospital system's electronic database and of state Medicaid billing records for 4 types of visits: preventive care, urgent care, emergency care, and hospital care. Cost of child health care use was provided by Medicaid billing records. Multivariate analysis included caregiver education, age, and language proficiency, as well as child age, special health care needs, ethnicity, and health-insurance coverage.RESULTS. A total of 290 dyads were enrolled in the study. Twenty-two percent of caregivers had low (inadequate or marginal) health literacy. Caregivers with low health literacy were more likely to have less than a high school education, to have limited English proficiency, and to have been born outside the United States. There were no differences in health care use or cost between children of caregivers with low health literacy and children of caregivers with adequate health literacy. Three caregiver characteristics were associated with increased use of child health care services: born outside the United States, age at child's birth < 24 years, and limited English proficiency.CONCLUSIONS. One in 5 caregivers of young children has low health literacy. Caregiver health literacy, however, was not associated with disparities in the use of child health services in this inner-city, ethnic minority population.