Scoping Out Health Care Literacy

I truly believe that a lot of smart people don’t understand and don’t apply some basic concepts about wellness, illness, treatments, the roles of the members of the health care team and how to interact with these pieces.  Throw into the mix the varying levels of coverage health insurers provide and the rules they have in place, and it’s no wonder many people are confused about what to do when they face a medical situation in their lives.

This gap in health care literacy is costly in terms of people’s health and additional cost to the system when they make choices that are ill-informed from the viewpoint of basic health principles.  Some may make a distinction between health literacy and health care literacy.  Health Literacy would be defined as the knowledge of wellness, illness, managing one’s acute and chronic conditions and responding medically appropriately when things change with one’s health.  Health Care Literacy might be defined as the knowledge of how to use the health care system, including where to get care when necessary and efficiently and effectively using your health care insurance benefits.  For simplicity, I’ll use Health Care Literacy in this blog to include both of these concepts since they are closely related.

So what are we talking about here?  In a recent (March 1, 2011) Washington Post article, Sandra G. Boodman from Kaiser Health News, cited several examples of low levels of health literacy, such as, misunderstandings of discharge instructions leading to the development of life-threatening infections, or individuals not using prescribed medications properly because they don’t understand the directions.  I would add to this list instances where people misjudge the severity of their symptoms and wait too long to contact their physician.  The delay often allows their condition to deteriorate further so that when they do seek care, the physician is forced to send them to the emergency room or admit them to the hospital.  Antibiotics that could have been taken by mouth if begun earlier must now be taken intravenously, often in the hospital with added risk of complications, poorer outcomes and higher cost.  I have personally heard about examples of this happening many times.  And these incidents add up.  Boodman references a 2007 study that estimated the cost of this problem to the US economy could be as much as $238 billion annually.   This problem is widespread as demonstrated by a 2006 survey published by the U.S. Department of Education which found that only 1 in 8 adults has the skills to deal with complex health material.

I plan to publish posts to help improve a person’s health care literacy.  They’ll talk about some basic approaches a savvy health care consumer can take to optimize their health, minimize the impact of illness and save money.  I welcome comments about this post as well as suggestions about related topics of interest to help guide the discussion.

Regards,

Dr. Bob