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The roles of low literacy and social support in predicting the preventability of hospital admission

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Abstract

BACKGROUND: Prior studies found higher hospitalization rates among patients with low literacy, but did not determine the preventability of these admissions or consider other determinants of hospitalization, such as social support. This study evaluated whether low literacy was a predictor for preventability of hospitalization when considered in the context of social support, sociodemographics, health status, and risk behaviors.

METHODS: A convenience sample of 400 patients, admitted to general medicine wards in a university-affiliated Veterans Affairs hospital between August 1, 2001 and April 1, 2003, completed a face-to-face interview to assess literacy, sociodemographics, social support, health status, and risk behaviors. Two Board-certified Internists independently assessed preventability of hospitalization and determined the primary preventable cause through blinded medical chart reviews.

RESULTS: Neither low literacy (< seventh grade) nor very low literacy (< fourth grade) was significantly associated with preventability of hospitalization. In multivariable analysis, significant predictors of having a preventable cause of hospitalization included binge alcohol drinking (P≤.001), lower social support for medical care (P<.04), ≤3 annual clinic visits (P<.005), and ≥12 people talked to weekly (P<.023) Among nonbinge drinkers with lower social support for medical care, larger social networks were predictive of preventability of hospitalization. Among nonbinge drinkers with higher support for medical care, lower outpatient utilization was predictive of the preventability of hospitalization.

CONCLUSIONS: While low literacy was not predictive of admission preventability, the formal assessment of alcohol binge drinking, social support for medical care, social network size, and prior outpatient utilization may enhance our ability to predict the preventability of hospitalizations and develop targeted interventions.

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Authors and Affiliations

  1. Jesse Brown VA Medical Center, Chicago, IL, USA

    Ahsan M. Arozullah MD, MPH, Taha Khan BS, Sindhu Kurup BA, Jeffrey Ryan MD, Michael Bonner MD & Robert Soltysik MS

  2. VA Midwest Center for Health Services and Policy Research, Hines, IL, USA

    Ahsan M. Arozullah MD, MPH

  3. Sections of General Internal Medicine and Health Promotion Research, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Ahsan M. Arozullah MD, MPH & Jeffrey Ryan MD

  4. Department of Health Policy and Administration, University of North Carolina, Chapel Hill, NC, USA

    Shoou-Yih D. Lee PhD

  5. Department of Emergency Medicine, Feinberg Medical School of Northwestern University, Chicago, IL, USA

    Paul R. Yarnold PhD

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  1. Ahsan M. Arozullah MD, MPH
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  2. Shoou-Yih D. Lee PhD
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  3. Taha Khan BS
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  4. Sindhu Kurup BA
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  5. Jeffrey Ryan MD
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  6. Michael Bonner MD
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  7. Robert Soltysik MS
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  8. Paul R. Yarnold PhD
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Correspondence to Ahsan M. Arozullah MD, MPH.

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The authors of this article have no conflicts of interest to declare.

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Arozullah, A.M., Lee, SY.D., Khan, T. et al. The roles of low literacy and social support in predicting the preventability of hospital admission. J Gen Intern Med 21, 140–145 (2006). https://doi.org/10.1007/s11606-006-0248-z

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  • DOI: https://doi.org/10.1007/s11606-006-0248-z

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