The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults

TLDR

Inadequate health literacy is linked to poorer healthcare choices and lower quality of care, especially among older adults in poorer health, underscoring the need for targeted education and care coordination. Our primary purpose was to estimate the prevalence of inadequate health literacy among two populations of AARP® Medicare Supplement insureds—sicker and healthier—identify characteristics of inadequate health literacy, and describe its impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. The study mailed surveys to insureds in 10 states and used multivariate regression models to identify characteristics of inadequate health literacy and adjust outcome measures. Among 7,334 respondents, 23% of sicker and 16% of healthier insureds had inadequate health literacy, which was associated with male gender, older age, more comorbidities, lower education, lower patient satisfaction, lower preventive service compliance, and higher healthcare utilization and expenditures.

Abstract

Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care. Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP® Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL. Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures. Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions.