Health Literacy Predicts Morbidity and Mortality in Rural Patients With Heart Failure

作者：Moser Debra K^*; Robinson Susan; Biddle Martha J; Pelter Michele M; Ne**itt Thomas S; Southard Jeffery; Cooper Lawton; Dracup Kathleen

来源：Journal of Cardiac Failure, 2015, 21(8): 612-618.

DOI：10.1016/j.cardfail.2015.04.004

• Health literacy
• heart failure
• rural

Background: Patients hospitalized with heart failure are often readmitted. Health literacy may play a substantial role in the high rate of readmissions. The purpose of this study was to examine the association of health literacy with the composite end point of heart failure readmission rates and all-cause mortality in patients with heart failure living in rural areas.
Methods and Results: Rural adults (n = 575), hospitalized for heart failure within the past 6 months, completed the Short Test of Functional Health Literacy in Adults (STOMA) to measure health literacy and were followed for >= 2 years. The percentage of patients with the end point of heart failure readmission or all-cause death was different (P = .001) among the 3 STOFHLA score levels. Unadjusted analysis revealed that patients with inadequate and marginal health literacy were 1.94 (95% confidence interval [CI] 1.43-2.63; P < .001) times, and 1.91 (95% CI 1.36-2.67; P < .001) times, respectively, more likely to experience the outcome. After adjustment for covariates, health literacy remained a predictor of outcomes. Of the other covariates, worse functional class, higher comorbidity burden, and higher depression score predicted worse outcomes.
Conclusions: Inadequate or marginal health literacy is a risk factor for heart failure rehospitalization or all-cause mortality among rural patients with heart failure.

• 出版日期2015-8