title: Assessing the health literacy levels of patients using selected hospital services.
abstract: OBJECTIVE
  The aim of this study was to assess the health literacy abilities of patients in an urban and suburban hospital.
  
  
  BACKGROUND
  Inadequate health literacy is a widespread problem that is associated with insufficient self-care knowledge and behavior, inappropriate use of emergency services, higher rates of hospitalization, and increased healthcare costs. Knowledge of patients' reading ability is necessary to ensure that appropriately leveled printed health education materials are available.
  
  
  METHODS
  The health literacy of a convenience sample of 21 inpatients and 34 outpatients from an urban and suburban hospital was measured using the Test of Functional Health Literacy in Adults and the Rapid Estimate of Adult Literacy in Medicine. Variables for analysis included demographic characteristics, perceived health status, highest grade of school completed, socioeconomic status, healthcare costs, and number of inpatient and outpatient admissions over the previous year.
  
  
  RESULTS
  Based on the Rapid Estimate of Adult Literacy in Medicine, 33% of patients had health literacy levels that were eighth grade or below, whereas according to the Test of Functional Health Literacy in Adults, 23% had marginal or inadequate functional health literacy. Literacy was significantly related to socioeconomic status (P < .001) and education (P < .001), although 30% of participants had a reading level below the highest grade completed. No other significant correlations were found.
  
  
  CONCLUSIONS
  Clinical nurse specialists should ensure that health information materials are written at appropriate levels and educate nurses and other healthcare professionals to use effective communication and teaching strategies.
authors.affiliation: School of Nursing, Purdue University Calumet, Hammond, Indiana, USA. walkerj@calumet.purdue.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Walker
authors.forename: Carole
authors.initials: C
authors.lastname: Pepa
authors.forename: Peggy S
authors.initials: PS
authors.lastname: Gerard
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012959:Socioeconomic Factors