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Health Literacy Impacts Hospitalizations for Patients With Cancer

October 24, 2017

Lower levels of health literacy are associated with a higher risk for hospital admissions and higher total days spent in the hospital for patients with cancer, according to research published in Health Literacy Research and Practice (October 2017;1[4]:e153-e162).

Hospitalization is almost always expensive, and many hospital admissions are potentially avoidable. Limited research has examined the relationship between health literacy and health outcomes for patients with cancer.

Laura A Cartwright, PhD, department of health behavior and policy, Virginia Commonwealth University, and colleagues conducted a secondary data analysis to assess whether health literacy can help predict hospitalizations for cancer patients, including total days spent hospitalized and number of 30-day readmissions. A total of 752 patients with cancer were included in the study, all of whom participated in the Cancer Health Literacy Study within the first 5 years after diagnosis.

Researchers utilized the Cancer Health Literacy Test 30 (CHLT-30) to measure patients’ health literacy. Multivariate negative binomial multiple regression was used to control for outcomes and potentially confounding variables.

After finding the mean CHLT-30 score to be 23.68, researchers observed a negative association between CHLT-30 score and number of inpatient hospital admissions (beta = -0.041; P = .009) and total days spent in the hospital (beta = -0.028; P = .023) Additionally, they found that with every one-point increase in CHLT-30 score, there was a 4% reduction in the number of inpatient hospital admissions and a 2.8% reduction in total number of days spent in the hospital.


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Researchers acknowledged that no significant association exists between CHLT-30 score and number of 30-day readmissions (beta = -0.002).

In their concluding remarks, researchers explained that the study’s finding of a negative relationship between health literacy and number of inpatient admissions and total number of days hospitalized for patients with cancer persisted after controlling for potentially confounding variables. “This study considered only counts of hospitalization, and future work should focus on the causes of hospitalizations and extended hospital stays to gain a better understanding of the role of health literacy,” they wrote.—Zachary Bessette   

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