Health Literacy and 30-Day Postdischarge Hospital Utilization

Figures & data

Table 1. Sociodemographic characteristics by health literacy status

	Health literacy status, by REALM* score
	1 ≤ 6th-grade level (n = 138)	2 7th–8th-grade level (n = 207)	3 ≥ 9th-grade level (n = 358)	Total	p
Gender
Female	63 45.7	113 54.6	196 54.9	372	.15
Male	75 54.4	94 45.4	161 45.1	330
Total	138	207	357	702
Marital status
Single, never been married	63 45.7	101 48.8	175 48.9	339	.07
Divorced, separated, or widowed	36 26.1	56 27.1	104 29.1	196
Unknown	7 5.1	1 0.5	5 1.4	13
Married	32 23.2	49 23.7	74 20.7	155
Total	138	207	358	703
Income
No income–$19,999	35 28.0	71 35.9	72 20.6	178	<.001
$20,000–$39,999	74 59.2	80 40.4	140 40.0	294
$40,000–$74,999	12 9.6	30 15.2	70 20.0	112
Unknown or refused	0 0.0	7 3.5	22 6.3	29
Total	125	198	350	673
Insurance
Free Care**	20 14.5	29 14.0	47 13.1	96	.02
Medicaid	70 50.7	97 46.9	133 37.2	300
Medicare	24 17.4	21 10.1	35 9.8	80
Other or unknown	8 5.8	10 4.8	30 8.4	48
Private	16 11.6	50 24.2	113 31.6	179
Total	138	207	358	703
Employment
Disabled or injured	46 35.1	53 25.7	74 21.0	173	.04
Part time	12 9.2	23 11.2	38 10.8	73
Retired	24 18.3	23 11.8	54 15.3	101
Student	2 1.5	4 1.9	9 2.6	15
Unemployed	29 22.1	56 27.2	61 17.3	146
Full time	18 13.7	47 22.8	116 33.0	181
Total	131	206	352	689
Education
Incomplete high school	60 43.5	62 30.0	44 12.3	166	<.01
Complete high school	55 39.9	91 44.0	120 33.5	266
Some college	9 6.5	33 15.9	106 29.6	148
Unknown	6 4.4	2 1.0	3 0.8	11
Complete college	8 5.8	19 9.2	85 23.7	112
Total	138	207	358	703
Race
Black	83 60.1	134 64.7	152 42.5	369	<.01
Hispanic	21 15.2	23 11.1	34 9.5	78
Other	7 5.1	9 4.4	16 4.5	32
Unknown	9 6.5	10 4.8	9 2.5	28
White	18 13.0	31 15.0	147 41.1	196
Total	138	207	358	703
Has primary care physician
No	28 20.3	38 18.4	57 15.9	123	.48
Yes	110 79.7	169 81.6	301 84.1	580
Total	138	207	358	703
Been homeless in the past 6 months
Yes	22 15.9	24 11.7	40 11.2	86	.33
No	116 84.1	182 88.4	318 88.8	616
Total	138	206	358	702
Depressive symptoms***
Depressive	40 29.0	45 21.7	78 21.8	163	.19
Not depressive	98 71.0	162 78.3	280 78.2	540
Total	138	207	358	703
Frequent utilizer status
Two or more admissions in the 6 months before index admission	41 29.7	54 26.1	111 31.0	206	.46
Fewer than two admissions in the 6 months before the index admission	97 70.3	153 73.9	247 69.0	497
Total	138	207	358	703
Age, M (SD)	51.23 (13.91)	49.42 (13.51)	48.14 (14.77)	702
Length of stay, M (SD)	2.69 (2.57)	2.86 (2.52)	2.72 (2.38)	702
Charlson Comorbidity Index, M (SD)	0.719 (1.592)	0.595 (1.382)	0.499 (1.341)	703	.03

Table 2. Adjusted incident rate ratio of hospital utilization within 30 days of discharge

	Multivariate Poisson regression with reutilization
	Estimate	Wald 95% confidence limits		p
Intercept	0.41	0.20	0.82	.01
REALM
≤6th grade	1.46	1.04	2.05	.03
7th and 8th grade	1.36	1.00	1.85	.05
≥9th grade	1.00	1.00	1.00
Education
Incomplete high school	0.96	0.62	1.48	.85
High school or equivalent	1.18	0.80	1.72	.40
Incomplete college	0.87	0.55	1.36	.54
Unknown	0.65	0.14	3.13	.59
Complete college	1.00	1.00	1.00
Gender
Female	0.75	0.58	0.96	.02
Male	1.00	1.00	1.00
Marital status
Single, never married	0.86	0.63	1.19	.37
Divorced, separated, or widowed	1.05	0.74	1.49	.78
Unknown	0.76	0.21	2.72	.68
Married	1.00	1.00	1.00
Insurance
Free Care*	1.15	0.73	1.80	.55
Medicaid	1.24	0.89	1.74	.21
Medicare	1.04	0.64	1.68	.88
Other or unknown	0.96	0.49	1.91	.92
Private	1.00	1.00	1.00
Race
Black	0.73	0.55	0.98	.04
Hispanic	0.73	0.47	1.12	.14
Other	0.76	0.46	1.25	.28
White	1.00	1.00	1.00
Has primary care physician
No	0.96	0.69	1.34	.82
Yes	1.00	1.00	1.00
Been homeless
Yes	1.54	1.14	2.08	.005
No	1.00	1.00	1.00
Depressive symptoms**
Depressive	1.24	0.96	1.60	.09
Not depressive	1.00	1.00	1.00
Frequent user
Two or more admissions	2.04	1.58	2.62	<.0001
Fewer than two admissions	1.00	1.00	1.00
Age, continuous, increment of 1 year	0.99	0.98	1.00	.14
Length of stay, continuous, increment of 1 day	0.99	0.94	1.04	.61
Charlson Comorbidity Index, continuous, increment of 1 unit	1.00	0.91	1.09	.92