This article is more than 5 years old. Information may no longer be current.

Lower health literacy increases risk for cancer-related hospitalizations

Health literacy independently predicted hospitalizations among patients with cancer, with lower levels indicating an elevated risk for hospital admissions and higher total days spent hospitalized, according to findings published in Health Literacy Research and Practice.

“Lower levels of health literacy predict higher hospitalization rates. Hospitalization is expensive, and many admissions are potentially avoidable,” Laura A. Cartwright, PhD, from the department of health behavior and policy at Virginia Commonwealth University, and colleagues wrote. “Research examining the relationship between health literacy and health outcomes for cancer patients is limited, and no published studies to date have focused on hospitalization and health literacy in cancer patients.”

Cartwright and colleagues performed a secondary data analysis to evaluate whether health literacy is a predictor of cancer patients’ hospitalizations, including total days spent hospitalized and number of 30-day readmissions.

The study included 752 patients with cancer who participated in the Cancer Health Literacy Study in the first 5 years after diagnosis. Cancer diagnoses were diverse and included all stages. The researchers used the Cancer Health Literacy Test 30 (CHLT-30) to measure patients’ health literacy. They controlled for the outcomes and potentially confounding variables using multivariate negative binomial multiple regression.

The controlled analysis demonstrated that the mean CHLT-30 score was 23.68. There was an independent negative association between CHLT-30 score and number of inpatient hospital admissions (beta = –0.041; P = .009) and total days spent hospitalized (beta = –0.028; P = .023). Every one-point increase in CHLT-30 score resulted in a 4% reduction in the number of inpatient hospital admissions and a 2.8% reduction in total number of days spent hospitalized. There was no significant association between CHLT-30 and number of 30-day readmissions (beta = –0.002).

“This study identified a negative relationship between health literacy and number of inpatient admissions and total number of days hospitalized in a sample of cancer patients,” Cartwright and colleagues concluded. “This robust finding 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.” – by Alaina Tedesco

Disclosure: Cartwright and Robin K. Matsuyama report receiving grants from the national Institutes of Health/National Cancer Institute. The other authors report no relevant financial disclosures.