Health literacy in an Israeli elderly population

Hochhauser, Michal; Brusovansky, Michael; Sirotin, Maria; Bronfman, Katerina

doi:10.1186/s13584-019-0328-2

Cited by 14 publications

(15 citation statements)

References 24 publications

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“…The finding that in higher socio-economic groups, the intervention had a more positive effect on adherence may give direction for the needed intervention. For example, knowing that health literacy is better in higher socio-economic groups [33,34] can direct health organizations to investigate further the benefits of increasing health literacy among its members, especially in those of low health literacy [ 35].…”

Section: Discussionmentioning

confidence: 99%

Does a policy that requires adherence to a regular primary care physician improve the actual adherence of patients?

Golan‐Cohen

Blumberg

Merzon

et al. 2021

Isr J Health Policy Res

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Background Continuity of care by the same personal physician is a key factor in an effective and efficient health care system. Studies that support the association between high adherence and better outcomes were done in settings where allocation to the same physician was a long-term policy. Objectives To evaluate the influence that changing organizational policy from the free choice of a primary care physician to a mandatory continuity of care by the same physician has on adherence to a personal physician. Methods A cross-sectional study based on electronic databases; comparison of adherence and demographic characteristics (sex, age, and socio-economic status) of 208,286 Leumit enrollees who met the inclusion criteria, according to change in the adherence to a personal physician. To evaluate adherence, we used the Usual Provider of Care (UPC) index, which measures the number of visits made to the personal doctor out of the total primary care physician visits over the same period. The patients were divided into groups according to their UPC level. Results The data shows that 54.5% of the patients were high adherers even before the organizational change; these rates are similar to those published by various organizations worldwide, years after mandating continuity of care by the same physician. In the year following the intervention, only 34.5% of the patients changed the level of their adherence group. Of these, 64% made a shift to a higher adherence group. Before the intervention, the high adherers were older (mean age 57.8 vs. 49.3 years in the low adherers group) and from a higher SES (mean SES status 9.32 vs. 8.71). After the intervention, a higher proportion of older patients and patients from a higher SES changed their adherence to a higher group. Sex distribution was similar over all the adherence level groups and did not change after the intervention. Conclusions and policy implications A policy change that encouraged adherence to an allocated primary care physician managed to improve adherence only in specific groups. Health organizations need to examine the potential for change and the groups they want to influence and direct their investment wisely. Trial registration retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Does a policy that requires adherence to a regular primary care physician improve the actual adherence of patients?

Golan‐Cohen

Blumberg

Merzon

et al. 2021

Isr J Health Policy Res

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“…Low levels of understanding (operationalized through respondents’ choice of “don’t know” when asked to assess the gravity of the information) were negatively correlated with an expectation of immediately calling the doctor, and positively correlated with searching the Internet, waiting for the doctor to contact the patient, and waiting for one’s next visit to the doctor. Thus, uncertainty regarding the meaning of the lab results drove participants to shift the burden of responsibility to their doctors, as well as to delay actively seeking medical services [ 23 , 35 ]. As Zikmund-Fisher and his colleagues found in their study [ 13 ], high perceived gravity of the health condition was the only predictor of immediately calling the doctor.…”

Section: Discussionmentioning

confidence: 99%

“…Recent definitions of e-health literacy consider the set of individual capacities that allow the person to acquire and use new information, as well as the cognitive competencies required to make judgments and decisions in everyday life concerning health [ 22 , 23 ]. E-health literacy has been shown to combine knowledge and skills from a wide variety of domains, and is inherently contingent upon the social contexts wherein it is developed and expected to be put into use.…”

Section: Introductionmentioning

confidence: 99%

Numbers, graphs and words – do we really understand the lab test results accessible via the patient portals?

Bar‐Lev

Beimel

2020

Isr J Health Policy Res

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Background The heavy reliance on remote patient care (RPC) during the COVID-19 health crisis may have expedited the emergence of digital health tools that can contribute to safely and effectively moving the locus of care from the hospital to the community. Understanding how laypersons interpret the personal health information accessible to them via electronic patient records (EPRs) is crucial to healthcare planning and the design of services. Yet we still know little about how the format in which personal medical information is presented in the EPR (numerically, verbally, or graphically) affects individuals’ understanding of the information, their assessment of its gravity, and the course of action they choose in response. Methods We employed an online questionnaire to assess respondents’ reactions to 10 medical decision-making scenarios, where the same information was presented using different formats. In each scenario, respondents were presented with real (anonymized) patient lab results using either numeric expressions, graphs, or verbal expressions. Participants were asked to assess the gravity of the hypothetical patient’s condition and the course of action they would follow if they were that patient. The questionnaire was distributed to more than 300 participants, of whom 225 submitted usable responses. Results Laypersons were more likely to overestimate the gravity of the information when it was presented either numerically or graphically compared to the narrative format. High perceived gravity was most likely to produce an inclination to actively seek medical attention, even when unwarranted. “Don’t know” responses were most likely to produce an inclination to either search the Internet or wait for the doctor to call. Policy recommendations We discuss the study’s implications for the effective design of lab results in the patient portals. We suggest (1) that graphs, tables, and charts would be easier to interpret if coupled with a brief verbal explanation; (2) that highlighting an overall level of urgency may be more helpful than indicating a diversion from the norm; and (3) that statements of results should include the type of follow-up required.

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“…Previous studies have reported several factors that were associated with HL levels among the elderly population. These include education level, ethnicity, income, age, cognitive status, presence of chronic diseases, information seeking through television or internet, and physical performance [4,23,[27][28][29][30][32][33][34][35]. Studies in China, Israel, and Germany reported that elderly persons with no or a low education had lower HL levels [27][28][29][30]33,34].…”

Section: Introductionmentioning

confidence: 99%

“…These include education level, ethnicity, income, age, cognitive status, presence of chronic diseases, information seeking through television or internet, and physical performance [4,23,[27][28][29][30][32][33][34][35]. Studies in China, Israel, and Germany reported that elderly persons with no or a low education had lower HL levels [27][28][29][30]33,34]. A Chinese study found that being in an ethnic minority group was associated with having limited HL [29].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Limited Health Literacy and Its Associated Factors among Elderly Patients Attending an Urban Academic Primary Care Clinic in Malaysia

Rahim

Mohamed-Yassin

Abdul-Razak

et al. 2021

IJERPH

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Limited health literacy (HL) is linked to many negative health outcomes, including poor self-management of chronic diseases and medication adherence among patients. There are a lack of data regarding HL in the elderly population in Malaysia. This study aimed to determine the prevalence of limited HL levels and its associated factors among elderly patients in an urban academic primary care clinic in Selangor, Malaysia. A cross-sectional study was conducted among 413 elderly patients (≥60 years old) who attended this academic primary care clinic between January 2020 and January 2021. Sociodemographic data, clinical characteristics, and health literacy scores were collected. Descriptive statistics (median with interquartile ranges (IQR), frequency, and percentages) and multiple logistic regression were utilized. The prevalence of limited HL in our population was 19.1% (95% CI: 15.3, 23). The middle-old (70–79 years) and very-old (≥80 years) age groups were more likely to have limited HL (aOR 4.05; 95% CI: 2.19, 7.52 and aOR 4.36; 95% CI: 1.02, 18.63, respectively). Those with at least secondary school education (aOR 0.06; 95% CI: 0.02, 0.24) and those who found medical information via the internet/television (aOR 0.21; 95% CI: 0.05, 0.93) had lower odds of having limited HL. In conclusion, having limited HL levels was not common among elderly patients in this primary care clinic. Further studies involving rural and larger primary care clinics in Malaysia are required to support these findings.

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Health literacy in an Israeli elderly population

Cited by 14 publications

References 24 publications

Does a policy that requires adherence to a regular primary care physician improve the actual adherence of patients?

Does a policy that requires adherence to a regular primary care physician improve the actual adherence of patients?

Numbers, graphs and words – do we really understand the lab test results accessible via the patient portals?

The Prevalence of Limited Health Literacy and Its Associated Factors among Elderly Patients Attending an Urban Academic Primary Care Clinic in Malaysia

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