Low health literacy is associated with patient-clinician discrepancy in the perceived severity of medical emergencies.

Introduction: Most adults in the United States and Europe have low health literacy (HL), which also has an impact on emergency care. It is unclear, whether low HL impairs the patients' ability to evaluate the seriousness of their emergency and if it increases patient-clinician disagreement. Methods: In this prospective cross-sectional study in a German tertiary-care emergency department (ED), 257 adults (median age = 55 y) self-assessed the severity of their condition on arrival; simultaneously, an ED nurse and physician provided independent assessments. Thirty days later, an expert panel reviewed each case and issued a specialist evaluation. HL was assessed with the 16-item European Health Literacy Survey (HLS-EU-Q16) and categorized as adequate ( Results: Patients with adequate HL showed the strongest alignment with clinicians ( Conclusion: Lower HL modestly but consistently enlarges the gap between patients' and clinicians' emergency assessments and is associated to a higher likelihood of a severe outcome via this mismatch. Although adequate HL improves agreement, half of these patients still struggle to evaluate severity. Routine teach-back communication might be helpful to identify discrepancies. These findings underscore the need for healthcare professionals to assess patients without prejudice, regardless of presenting symptoms, to ensure optimal medical care. Trial registration: Identifier, DRKS00032962.