UNDERSTANDING HEALTH LITERACY AS A HEALTH CARE COST

E. KELLY, 2016

WEBINAR OCTOBER 22, 2015

PRESENTER – ELIZABETH KELLY, PH.D., RN., APN-CH

E. Kelly, 2016

YOUR IDEAS ABOUT HEALTH LITERACY

U.S. HEALTH CARE EXPENDITURES ARE THE HIGHEST IN THE WORLD?

Y N

$9,255.00

$2.9 TRILLION

17.4% GDP (2013)

SOURCES: CDC; AETNA.ORG

• MOST EXPENSIVE HEALTH CARE IN THE WORLD; • LOWEST RESULTS IN ACCESS EFFICIENCY EQUITY HEALTHY LIVES• OVERALL RANKING = 11TH OF 11 INDUSTRIALIZED NATIONS

• SOURCE: COMMONWEALTH FUND (2014); OECD

U. S. HEALTH CARE DOLLAR DISTRIBUTION (2013)

• HOSPITAL CARE (32.1%) • PHYSICIAN AND CLINICAL SERVICES (20.1%)• PRESECRIPTION DRUGS (9.3%)• NURSING HOME FACILITIES AND CONTINUING

CARE (RETIREMENT COMMUNITES) (7.3%)• OTHERS (33.2%) RESEARCH, HEALTH LITERACY,

HOME HEALTH, EQUIPMENT

• SOURCES: CDC, AETNA.ORG

U. S. HEALTH EXPENDITURE OUTCOMES

• LIFE EXPECTANCY;

• EMERGENCY ROOM VISITS;

• INFANT MORTALITY;

• HEALTH STATUS

• SOURCES: WORLD BANK, ORG; OECD; HEALTHY PEOPLE 2020

HEALTH LITERACY in the U. S.• ISSUE EMERGED 10 YEARS AGO

• DEFINED AS - “DEGREE TO WHICH INDIVIDUALS HAVE THE CAPACITY TO OBTAIN, PROCESS, UNDERSTAND BASIC HEALTH INFORMATION AND SERVICES NEEDED TO MAKE APPROPRIATE HEALTH DECISIONS.”

• SOURCES: IOM; PUBLICHEALTH.GWU.EDU

HEALTH LITERACY DISTRIBUTION IN THE U.S. (2003)

HEALTH LITERACY LEVELS DEFINITIONS PERCENTAGES

BELOW BASIC LOCATE NUMBERS AND INFORMATION;FOLLOW SIMPLE DIRECTIONS

14%

BASIC READ AND UNDERSTAND INFORMATION;SOLVE SIMPLE PROBLEMS

22%

INTERMEDIATE READ AND UNDERSTAND COMPLEX DOCUMENTS;PROBLEM SOLVE

52%

PROFICIENT READ AND SYNTHESIZE INFORMATION;MULTI-STEP PROBLEMSSOURCE: NAAL (2003); PUBLICHEALTH.GWU.EDU

12%

U. S. HEALTH CARE COSTS FROM HEALTH LITERACY

• $7,500.00 PER PERSON/YEAR

• COSTS THE ECONOMY = $106 - $238 BILLION YEARLY

• WITHOUT ADDRESSING THE ISSUE = HEALTH CARE COSTS RISE TO $1.6 - $3.6 TRILLION

• SOURCES: NNLM; PUBLICHEALTH.GWU.EDU; IOM (2004 & 2O15)

HEALTH LITERACY INFLUENCES

• TREATMENT KNOWLEDGE AND CHOICES;• LOWER ADHERANCE TO TREATMENTS;• ONGOING POOR HEALTH STATUS;• HIGHER MORTALITY RATES;• INCREASE MEDICATION ERRORS;• USE OF MEDICATION;• UNDERSTANDING HEALTH INSURANCE

• SOURCES: AHRQ; HEALTHLEADERMEDIA.COM

• OVER 65 YEARS OLD;• WITHOUT HIGH SCHOOL/GED EDUCATION;• LOW INCOME;• NON-ENGLISH SPEAKERS;• THOSE WITH LIMITED ACCESS TO HEALTH

CARE;• LEARNING DISABILITIES• SOURCES: NNLM, IOM

– STEP 1

• ACKNOWLEDGE IMPORTANCE OF THE ISSUE;• APPLY QUALITY MEASURES FROM ACA;• INCREASE HIGH SCHOOL GRADUATION RATES;• CHANGES WITHIN THE HEALTH CARE SETTING: IMPROVE SIGNAGE; IMPROVE FORMS; FOLLOW-UP AT DISCHARGE PLANNING; FOLLOW-UP AFTER HEALTH CONTACT• SOURCES: IOM; PUBLICHEALTH.GWU.EDU

• HEALTH LITERACY RESOURCES SOCIAL DETERMINANTS FROM HEALTHY PEOPLE 2020; “HEALTH LITERACY UNIVERSAL PRECAUTIONS TOOL KIT” INCLUDE TEACH BACK/TALK BACK;

• HEALTH LITERACY POLICY INCLUDE IN HEALTH DISPARITIES; INCLUDE COMMUNITY REPRESENTATIVES; • SOURCES: AHRQ; IOM; ACA; ADULT LEARNING THEORY

• “HEALTH LITERACY IS AN UNDER-RECOGNIZED, SILENT EPIDEMIC TO AN ISSUE OF HEALTH POLICY AND REFORM.”

• “HEALTH LITERACY IS NOT GLAMOROUS, BUT IT IS AT THE CORE OF EVERYTHING WE DO.”

• SOURCES: NNLM; IOM

E E. KELLY, 2016

• TO EACH OF YOU WHO PARTICIPATED IN TODAY’S WEBINAR

• E. E. KELLY, 2016

REFERENCESORGANIZATIONS

• Retrieved from http://www.Agencyforhealthresearchqulaity.gov (AHRQ)• Retrieved from http://www.Centerfordiseasecontrol.gov (CDC)• Retrieved from http://www.Healthypeople.gov (2020)• Retrieved from http://www.Health.gov• Retrieved from http://www.Aetna.org• Retrieved from http://www.Commonwealthfund.org (2014)• Retrieved from http://www.Susangkomen.org• Retrieved from http://www.Cancer.org (American Cancer Society)• Retrieved from http://www.OEDC.org• Retrieved from http://www.Instituteofmedicine.org• Retrieved from http://www.nationaladultassessmentleague (2003) (NAAL)• Retrieved from http://www.healthleadermedia.com• Retrieved from http://www.Publichealth.gwu.edu

E. Kelly, 2016

REFERENCES

LEGISLATION

• Retrieved from http://www.Healthcare.com (ACA) Quality of Care and Delivery Systems, Section 2701, Title !! – Role of Public Programs

AUTHORS

• Baker, D. (2007) Health Literacy and Mortality Among Elderly Persons. JGIM, 19,(3): 215-220.• Friedman, N. (2015) What we’re not ‘Feeling’ Health Literacy. Huffington Post (07/10/15)• Mantell, M (2014) Health Literacy-Huh. Huffington Post (06/02/14)

E. Kelly, 2016