title: Health Literacy and Time Spent With a Hand Surgeon.
abstract: OBJECTIVE
  To characterize the relationship between health literacy and duration of new hand surgery office visits.
  
  
  METHODS
  Using a stopwatch from outside the room, we measured the duration of the visit (minutes of face-to-face contact between attending surgeon and patient) for 224 new patients presenting to 1 of 5 orthopedic hand surgeons (D.R.). Directly after the visit, patients were asked to complete the Newest Vital Sign (NVS) health literacy test, a sociodemographic survey, and 3 Patient-Reported Outcomes Measurement Information System-based questionnaires: Pain Interference, Upper Extremity Function, and Depression. The Newest Vital Sign scores were divided into limited (0-3) and adequate (4-6) health literacy. Medical records were reviewed to collect data on diagnosis, visit type, management, and whether patients were first seen by a resident/fellow. Multiple linear regression modeling was used to characterize the association between health literacy and duration of visit while controlling for the effect of other patient and visit characteristics.
  
  
  RESULTS
  The unadjusted mean visit duration was 1.9 minutes shorter in patients with limited health literacy (9.4 minutes) than in patients with adequate health literacy (11.3 minutes), and this difference persisted after adjustment for a broad range of patient and visit characteristics. Greater magnitude of disability was associated with longer visits, as were second-opinion appointments, a diagnosis of nonspecific arm pain or compression neuropathy, and appointments in which operative management was chosen. Visits in which a resident/fellow saw the patient first were shorter than visits without resident/fellow assistance.
  
  
  CONCLUSIONS
  The finding that limited health literacy correlated with shorter visits may suggest that patients who may stand to benefit the most from detailed health education and counseling received less.
  
  
  METHODS
  Prognostic II.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Menendez
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Parrish
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: dring@partners.org.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D005260:Female; D006225:Hand / Q000601:surgery*; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D009985:Orthopedics; D010817:Physician-Patient Relations; D013997:Time Factors
keywords: Health literacy; hand surgery; patient-centered care; visit duration