The Research On The Relation Between Health Literacy And Quality Of Life, Direct Medical Costs Of Middle-aged Of Elderly Hospitalized Patients With Coronary Heart Disease

Objective: To study the status and influencing factors of health literacy among middle-aged and elderly hospitalized patients with coronary heart disease and to explore the health literacy’ influence on their quality of life and the direct medical costs. These can provide a theoretical basis on making a healthy intervention plan, intervening healthy literacy scientifically, improving the patients’ quality of life and reduce disease direct medical cost. methods: A stratified cluster random sampling method was selected, use middle-aged and elderly hospitalized patients met inclusion and exclusion criteria with coronary heart disease in a 3A-level hospital of Urumq as the research objects. Investigators got information through face-to-face interviews and hospital medical records management system to obtain the health literacy, quality of life and direct medical costs. Results: 1. The score of healthy literacy of middle-aged and elderly hospitalized patients with coronary heart disease was 76.46±30.57, 25.54% of the patients’ healthy literacy level were good. Single factor analysis of healthy literacy showed that men than women. Han were higher than the minority. 45~54 years old age group were highest. the higher level of education were, the higher of healthy literacy level were. With the improvement of career level, the healthy literacy was gradually improved, the highest healthy literacy existed in unit leaders and professional technical personnel. The better of household income or family care situation was, the better of healthy literacy was. In different course, patients’ healthy literacy level in 1~3 years of the course was higher than two course groups of less than 1 and 3~5 years. The healthy literacy of patients with family history of coronary heart disease were higher than who have not. Healthy literacy of patients who have PCI or PTCA were higher than who have not. People in different coronary artery lesions, whose coronary artery lesions uping to three had the worst healthy literacy.Independent factors of health literacy scores including gender, nationality, education level, occupation, coronary artery lesion, PCI or PTCA and family care. 2. Quality of life of middle-aged and elderly hospitalized patients with coronary artery disease were in a low level. EQ-5D health index score of the patients with coronary heart disease was 0.76±0.19, and the overall health score was 66.31±12.38. On the five dimensions of EQ-5D scale, coronary heart disease patients’ health problems mainly concentrated in three dimensions of the daily activities, pain/discomfort and anxiety/depression. In the three dimensions, patients have problems of different level which was respectively 48.20%, 59.89% and 36.51%. In addition, only 1.08%(6/556) patients thought their overall health score surpass 85 points. There was a big relationship between health literacy and quality of life, Pearson correlation coefficient was 0.665, relevance of health knowledge and skills were the largest. 3. The direct medical costs of patients with coronary heart disease was 29864.98(17244.09,58587.66) yuan, which was a heavy economic burden. Health literacy had significant influence on direct medical costs, Spearman correlation analysis showed that the relation between health literacy and outpatient costs was positively correlated, and the relation between healthy literacy and hospitalization expenses was negatively correlated, and the relation between healthy literacy and pharmacy expenses was not obvious. Conclusion: 1.Healthy literacy level of the middle-aged and elderly hospitalized patients with coronary heart disease is low. The key object of healthy literacy intervention are those patients who are female, minority, lower education level, poor professional level, severe coronary artery disease, not implementation of PCI or PTCA and poor family care. 2. Relationship between the quality of life and health literacy of patients with coronary heart disease is great, especially, the relationship between quality of life and health knowledge, health skll is the most closely. At present, the middle-aged and elderly hospitalized patients with coronary artery disease have a low quality of life, limited daily activities, pain/discomfort and anxiety/depression are the three major health problems that affect their quality of life. 3. The healthy literacy of middle-aged and elderly hospitalized patients with coronary heart disease have a positive impact on reducing the direct medical costs. The middle-aged and elderly hospitalized patients with coronary artery disease have great economic burden, the relevant departments should pay more attention on building healthy literacy education system and other related work for coronary heart disease in later healthy service work, so that they can spontaneously carry out health behavior adjustment, regular follow-up examination, reasonably use of health services resources,improve the symptoms of disease, improve the quality of life, and ultimately achieve the goal of reducing the cost of health care.