Document Type : Original Article
Authors
1 Associate Professor, Health Services Management, Health Management and Economics Research Center, Faculty of Management and Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Health Services Management, Human Sciences in Health, Faculty of Management and Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Biostatistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
4 MSc Student, Health Services Management, Faculty of Management and Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Introduction: Health literacy is the degree to which people understand the health information and can operate in the health care system. Consequences of low health literacy occur both directly and indirectly. Therefore, the aim of this study was to determine health literacy, health status and health services utilization and their relationships in adults in Isfahan. Methods: This study was a descriptive analytical survey on 300 (18-64 years old) people in Isfahan, multi stage sampling was performed. For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare Providers and Systems) health literacy questionnaire was used. Health status was measured by self-assessment of physical and mental health over the last 6 months. Health services utilization was asked by six areas that include the number of GP visits, number of special physician visits, number of outpatient or clinic visits, number of the emergency department visits, number of diagnostic services use of the last 3 months and the hospitalization in the past year. For data analysis SPSS18 software, descriptive statistics and Chi-square test was used. Results: Average health literacy score was 2.4, which was moderate. The average health status score was 3.1, which was good and the average health services utilization score was 2.1, which was weak. Health literacy, health status and health care utilization were not statistically significant. Levels of education and place of residence were effective on health services utilization. Conclusion: According to the average prevalence of health literacy in adults in Isfahan and low health services utilization, more attention to the improvement of health literacy and doctor-patient relationship and awareness of community through health programs and media was recommended. Keywords: Health Literacy; Health Status; Health Services; Utilization
Keywords
- Just what did the doctor order? Addressing Low Health Literacy in North Carolina, The North Carolina Institute of Medicine,2007.
- Tsai, T et al., Methodology and Validation of Health Literacy Scale Development in Taiwan. Journal of Health Communication The George Washington University, 2009.
- Report on the Council of Scientific Affairs,Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association,1999.
- Tehrani Bani-Hashemi A, et al., Health Literacy in five provinces of the country and its influencing factors. Journal of Medical Education& Development Center, 1386. 4(1): p. 1-9.
- Kickbusch , S and D. Maag, NAVIGATING HEALTH THE ROLE OF HEALTH LITERACY.
- Map of Iran's health system in 1404. Values, principles, vision.
- Healthy People 2010 Objectives:Draft for Public Comment. Washington, DC: Public Health Service, U.S. Department of Health and Human Services,1998.
- Williams, M.V., et al., Relationship of Functional Health Literacy to Patient’s Knowledge of Their Chronic Disease: A Study of Patients with Hypertension and Diabetes. Archives of Internal Medicine, 1998. 158 (2)
- Report on the Council of Scientific Affairs, Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs,1999. American Medical Association JAMA, Feb 1999.
- Baker, D.W., et al., The Relationship of Patient Reading Ability to Self-Reported Health and Use of Health Services. American Journal of Public Health, 1997. 87(6)
- Report on the Council of Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association, JAMA, Feb 10, 1999.
- Gazmararian, J., et al., Health Literacy Among Medicare Enrollees in a Managed Care Organization. Journal of the American Medical Association, 1999. 281(6)
- Green, S.N., et al., Health Literacy among Medicare Enrollees in a Managed Care Organization. Journal of the American Medical Association 1999.
- Health interview surveys:Towards international harmonization of methods and instruments, in WHO Regional Office for Europe (WHO Regional Publications, European Series, n. 58, Editor. World Health Organization,Statistics Netherlands: Copenhagen ,1996.
- Manderbacka K, et al., The effect of point of reference on the association between self-rated health and mortality. Social Science of Medicine, 2003. 56
- Donald, L., et al., Associations Between Older Adults'Spoken Interactive Health Literacy and Selected Health Care and Health Communication Outcomes. Journal of Health Communication, 2011.
- About the CAHPS Item Set for Addressing Health Literacy CAHPS Clinician & Group Survey and Reporting 2009.
- Cho, Y., et al., Effects of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med, 2008. 66(8)
- Arozullah, A., et al., The roles of low literacy and social support in predicting the preventability of hospital admission. J Gen Intern Med 2006. 21(2)
- Baker, D.W., et al., Health Literacy and Use of Outpatient Physician Services by Medicare Managed Care Enrollees. J GEN INTERN MED, 2004. 19
- Reisi, M., et al., The Relationship between Health Literacy, Health Status and Healthy Behaviors among Elderly in Isfahan, Iran Health system research journal, 2011. 7(4)
- Baker, D., et al., Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. Am J Public Health, 2002. 92(8)
- Walker, J., C. Pepa, and P.S. Gerard, Assessing the Health Literacy Levels of Patients Using Selected Hospital Services. Clinical Nurse Specialist, 2010. 24(1)
- Nancy, D., et al., Low Health Literacy and Health Outcomes: An Updated Systematic Review. Annals of Internal Medicine 2011. 155(2)
- David Kindig , et al., HEALTH LITERACY: A P RESCRIPTION TO END CONFUSION. INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES. National Academies Press, Washington, 2004.
- Lee, S.-Y.D., et al., Health literacy, health status, and healthcare utilization of Taiwanese adults: results from a national survey. BMC Public Health, 2010. 10(614)
- Hardie, N.A., et al., Health Literacy and Health Care Spending and Utilization in a Consumer-Driven Health Plan. Journal of Health Communication,2012.16
- Guerra, C.E. and J.A. Shea, Health literacy and perceived health status in Latinos andAfrican Americans. Ethnicity & Disease, 2007. 17(2)
- Jovic-Vranes, A., V. Bjegovic-Mikanovic, and J. Marinkovic, Functional health literacy among primary health-care patients: data from the Belgrade pilot study. J Public Health (Oxf), 2009. 31(4)
- Tokuda, T., et al., Health literacy and physical and psychological wellbeing in Japanese adults. Patient Education and Counseling 2009. 75(3)
- Kutner, M., et al., The Health Literacy of America’s Adults. NAAL.U.S. Department of Education, 2006.
- Wolf, M., J. Gazmararian, and D. Baker, Health literacy and functional health status among older adults. Arch Intern Med, 2005. 165(17)
- Berkman, N.D., et al., Health literacy interventions and outcomes: An updated systematic review. Agency for Healthcare Research and Quality, 2011.
)