Implementation of a Post Discharge Transition Care Model to Improve Emergency Department Discharge Outcomes in the Elderly Population with Inadequate Health Literacy

As a whole, low health literacy affects the entire population, but disproportionately affects older adults. Investigators have uncovered the prevalence of limited health literacy and the relationship of limited health literacy with patients' knowledge, health behaviors, rising medical costs, and health outcomes. Of the 38 million U.S. seniors aged 65 and older in 2007, approximately 11 million of them lacked the skills they needed to manage their health, and the literature suggests that number will reach seventy-one million by 2030 (Hastings, Mitchell, & Heflin, 2004).As the population continues to age, the number of visits by patients greater than 65 years old is expected to represent a significant proportion of ED visits (Roberts, McKay, & Shaffer, 2006). Over the last decade, health literacy has increasingly become an area of focused research. Growing evidence suggests that elder patients, who have been assessed to have low health literacy, and who are evaluated and released from the ED, are at higher risk for short-term medical deterioration and require close medical surveillance with ready access to ancillary health services(Herndon, Chaney & Carden, 2011).Low health literacy may influence ED visit-related outcomes, subsequent ED use, and post discharge hospital readmissions. Emergency Department recidivism by older adults, secondary to low health literacy, may be a sentinel event signifying a breakdown in care coordination for this population. The purpose of this paper is development of a transition care model that has the potential to reduce fragmentation of care and subsequent emergency department utilization.;Key Words: health literacy, elderly, recidivism, transition care.