ArticleHealth literacy research and practice2017
Patient Activation Mediates Health Literacy Associated with Hospital Utilization among Whites.
Article in Health literacy research and practice, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Empirically Tested Health Literacy Frameworks.Health literacy research and practice · 2020Pooled it
- Relationship between patient activation and utilisation of health care and harm reduction services among people who inject drugs in Baltimore, Maryland.Drug and alcohol review · 2024Article
- A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Moderators and Mediators of the Relationship of Shared Decision-Making and Satisfaction.Journal of patient experience · 2023Article
- Knowledge about Treatment (KaT) in Mental Health Services.Measurement and evaluation in counseling and development : the official publication of the Association for Measurement and Evaluation in Counseling and Development · 2023Article
- Are Health Literacy and Patient Activation Related to Health Outcomes in Breast Cancer Patients?Health literacy research and practice · 2021Article
- Comprehensive Health Literacy Among Undergraduates: A Ghanaian University-Based Cross-Sectional Study.Health literacy research and practice · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundReducing the 30-day hospital readmission rate is a national priority and patient activation has emerged as a modifiable target to reduce hospital readmissions.
objectivePrior studies demonstrate that low patient activation and low health literacy are each associated with higher rates of hospital utilization. The aim of this study was to use path analysis methods to assess if patient activation mediates the relationship between health literacy and hospital utilization in the 30 days after discharge. DESIGN AND
participantsWe performed a secondary analysis of data from a randomized controlled trial of patients receiving care at an urban safety net hospital. Path analyses were used to assess patient activation as a mediator of the relationship of education and health literacy with 30-day hospital utilization. The final model was stratified by race and ethnicity. MEASURE: 30 day Hospital Utilization.
resultsIn the overall study sample, a one standard deviation (SD) higher patient activation measure (PAM) score was associated with 18% reduced odds of hospital utilization (odds ratio (OR) 0.82, 95% confidence interval (CI): 0.73, 0.91, p=<0.001). PAM mediated the relationship between education level and health literacy and hospital utilization. When stratified by race, the mediating effect of PAM was evident among Whites, but not among non-Whites. Specifically, a one SD higher PAM score was significantly associated with a 33% reduced odds of utilization among Whites (OR 0.67, 95% CI: 0.57, 0.79, p<0.001). With the inclusion of PAM in the model, there was no direct relationship between either health literacy or education and 30-day hospital utilization.
conclusionPatient activation is only associated with hospital utilization among Whites. Further research is needed to assess if this selective protection is seen in other cohorts. Potential interventions to reduce hospital readmissions may need to consider other modifiable factors in racially and ethnically diverse populations.
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