title: Functional health literacy and the risk of hospital admission among Medicare managed care enrollees.
abstract: OBJECTIVE
  This study analyzed whether inadequate functional health literacy is an independent risk factor for hospital admission.
  
  
  METHODS
  We studied a prospective cohort of 3260 Medicare managed care enrollees.
  
  
  RESULTS
  Of the participants, 29.5% were hospitalized. The crude relative risk (RR) of hospitalization was higher for individuals with inadequate literacy (n = 800; RR = 1.43; 95% confidence interval [CI] = 1.24, 1.65) and marginal literacy (n = 366; RR = 1.33; 95% CI = 1.09, 1.61) than for those with adequate literacy (n = 2094). In multivariate analysis, the adjusted relative risk of hospital admission was 1.29 (95% CI = 1.07, 1.55) for individuals with inadequate literacy and 1.21 (95% CI = 0.97, 1.50) for those with marginal literacy.
  
  
  CONCLUSIONS
  Inadequate literacy was an independent risk factor for hospital admission among elderly managed care enrollees.
authors.affiliation: Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, USA. dwbaker@northwestern.edu
authors.forename: David W
authors.initials: DW
authors.lastname: Baker
authors.forename: Julie A
authors.initials: JA
authors.lastname: Gazmararian
authors.forename: Mark V
authors.initials: MV
authors.lastname: Williams
authors.forename: Tracy
authors.initials: T
authors.lastname: Scott
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Parker
authors.forename: Diane
authors.initials: D
authors.lastname: Green
authors.forename: Junling
authors.initials: J
authors.lastname: Ren
authors.forename: Jennifer
authors.initials: J
authors.lastname: Peel
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004522:Educational Status; D005006:Ethnicity / Q000193:education; D005260:Female; D006266:Health Education; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014504:Urban Health