Abstract 10658: Relationship Between Poor Health Literacy and Heart Failure Readmissions

Abstract

Background: Patients admitted with heart failure (HF) are often readmitted again. This poses a large public health burden and has become a compelling topic in the readmission healthcare reform debate. This analysis is based on a rural population enrolled in a randomized clinical trial (RCT) with an education intervention to reduce HF related hospitalization. We examined the association of the Short Test of Functional Health Literacy Assessment (STOFHLA) levels with the 2-year readmission rate.

Methods and Results: 614 rural-dwelling adults, hospitalized for HF within the last 6 months, (mean age 66.0 ± 13.0 years, 58.8% male). 575 patients completed the two-year follow-up and the baseline STOFHLA questionnaire, of which 172 (29.9%) were readmitted. The percent of patients with a readmission was significantly different (p=0.01) among the three STOFHLA score levels: Inadequate = 40%, Marginal = 34.4%, and Adequate = 25.7%. After adjusting for demographic co-variates independently, patients with an Inadequate STOFHLA level were nearly twice as likely to be readmitted compared to patients with an Adequate level (OR=1.9, CI 95% 1.23 to 3.01), using logistic regression. The effect of literacy level on readmission rate was similar across study arms.

Conclusion: ‘Inadequate’ health literacy is significantly associated with more likely re-hospitalization than ‘Adequate’ health literacy. THE STOFHLA questionnaire may be a useful tool in identifying patients at higher risk for readmission, and new ways to deliver customized interventions for rural HF patients with ‘Inadequate’ levels of health literacy are needed.