Lower Numeracy Is Associated with Increased Odds of 30-Day Emergency Department and Hospital Recidivism for Patients with Acute Heart Failure.
Circ Heart Fail. 2012 Dec 10;
Authors: McNaughton CD, Collins S, Kripalani S, Rothman R, Self WH, Jenkins C, Miller K, Arbogast P, Naftilan A, Dittus RS, Storrow AB
BACKGROUND: -More than 25% of Medicare patients hospitalized for heart failure are readmitted within 30 days. The contributions of numeracy and health literacy to recidivism for patients with acute heart failure (AHF) are not known. METHODS AND RESULTS: -A cohort of patients with AHF who presented to four emergency departments between January 2008 and September 2011. Research assistants administered subjective measures of numeracy and health literacy; thirty-day follow up was performed by phone interview. Recidivism was defined as any unplanned return to the emergency department or hospital within 30-days of the index emergency department visit for AHF. Multivariable logistic regression adjusting for patient age, gender, race, insurance status, hospital site, days eligible for recidivism, chronic kidney disease, abnormal hemoglobin, and low ejection fraction evaluated the relationships between numeracy and health literacy with 30-day recidivism. Of the 709 patients included in the analysis, 390 (55%) had low numeracy skills and 258 (37%) had low literacy skills. Low numeracy was associated with increased odds of recidivism within 30 days (adjusted odds ratio (OR) 1.41, 95% confidence interval 1.00-1.98, P=0.048). For low health literacy, adjusted OR of recidivism was 1.17 (95% CI 0.83-1.65, P=0.37). CONCLUSIONS: -Low numeracy was associated with greater odds of 30-day recidivism. Further investigation is warranted to determine whether addressing numeracy and health literacy may reduce 30-day recidivism for patients with acute heart failure.
PMID: 23230305 [PubMed - as supplied by publisher]