Health literacy: The impact on emergency room recidivism and cost containment

Overuse of Emergency Departments (EDs) has become a common issue in healthcare organizations across the country for decades. Adult patients with low literacy levels and especially those with low health literacy levels are increasingly likely to use the ED more often, resulting in significantly higher medical costs. In addition, these adults often remain longer in the hospital and return to the ED more often driving both additional cost and medical redundancy. Research indicates that low health literacy disproportionately affects the poor, less educated, the elderly, and in many cases, minority and immigrant populations. When these same adults are also parents, their children may not receive proper care and medical attention. Healthcare personnel must develop and disseminate health and safety information that is accurate yet accessible. Before addressing the needs of patients, an adequate assessment of the patient's literacy skills should be ascertained. Emergency Department personnel must develop a screening process for literacy levels during the intake process. Research in this capstone focused on interventions designed to improve comprehension in ED to reduce over use of these services and economize Department expense. This project was conducted at the Crouse Hospital ED in Syracuse, New York. Data was collected aimed at analyzing the variance in literacy levels of patients that frequented the Emergency Department. In this study the author demonstrated that there is an alarming discrepancy between the ED patient literacy levels that were recorded in the data sample and the reading skills that were required to sufficiently comprehend important written medical information. If written material that is disseminated to patients in the ED is to serve its purpose the patients must be surveyed via a reading assessment to determine reading levels and then the written materials must be adjusted appropriately.