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Parental Health Literacy and Acute Care Utilization in Children With Medical Complexity
Emily J Goodwin1,2,3, Isabella Zaniletti4, Joy Solano1,2,3
1Children's Mercy Kansas City, Kansas City, Missouri.
Insights
Parental health literacy impacts healthcare costs for children with medical complexity. While overall literacy wasn't linked to utilization, needing help with health materials significantly increased emergency and hospitalization expenses.
Area of Science:
- Pediatric Healthcare
- Health Literacy Research
- Healthcare Economics
Background:
- Health literacy significantly influences health decisions and outcomes.
- Inadequate health literacy is linked to health disparities and increased healthcare utilization.
- Children with medical complexity (CMC) frequently utilize acute care services.
Purpose of the Study:
- To investigate the association between parental health literacy and acute care utilization and costs in children with medical complexity.
- To determine if parental ability to understand health materials affects healthcare spending for CMC.
Main Methods:
- A cross-sectional study involving parents of CMC receiving primary care.
- Parental health literacy assessed using the Single Item Literacy Screener.
- Acute care utilization (ED visits, hospitalizations) and costs were primary outcomes.
Main Results:
- Overall inadequate health literacy was not associated with acute care utilization or costs.
- However, CMC whose parents required assistance with health materials incurred significantly higher ED and hospitalization costs.
- Sensitivity analysis revealed a 188% increase in ED costs and 126% increase in hospitalization costs for these families.
Conclusions:
- Inadequate parental health literacy alone did not correlate with increased acute care use in CMC.
- Assistance needed for reading health materials by parents is associated with substantially higher healthcare costs for CMC.
- Further multicenter research is recommended to validate these findings.
Objective:
Health literacy is the ability to find, understand, and use information and services to inform health-related decisions and actions. Inadequate health literacy is associated with health disparities, poor health outcomes, and increased emergency department (ED) visits and hospitalizations. Children with medical complexity (CMC) have high rates of acute health care utilization. We examined the association of parental health literacy with acute care utilization and costs in CMC.
Methods:
This cross-sectional study included parents of CMC receiving primary care at a free-standing children's hospital. We measured parental health literacy using the Single Item Literacy Screener, which measures the assistance needed to read health care materials. Our main predictor was parental health literacy, categorized as adequate versus inadequate. In a sensitivity analysis, we categorized health literacy as never needing assistance versus needing any assistance. Main outcomes were annual ED visits, hospitalizations, and associated costs.
Results:
Of the 236 parents of CMC, 5.5% had inadequate health literacy. Health literacy was not associated with acute care utilization or associated costs. In our sensitivity analysis, CMC whose parents need any assistance to read health care materials had 188% higher ED costs (adjusted rate ratio 2.88 [95% confidence interval: 1.63-5.07]) and 126% higher hospitalization costs (adjusted rate ratio 2.26 [95% confidence interval: 1.49-3.44]), compared with CMC whose parents never need assistance.
Conclusions:
Inadequate parental health literacy was not associated with acute care utilization. However, CMC of parents needing any assistance to read health materials had higher ED and hospitalization costs. Further multicenter studies are needed.
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