title: The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults.
abstract: Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care. Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP®Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL. Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures. Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions.
authors.affiliation: Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: MacLeod
authors.affiliation: Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA. Electronic address: shirley.musich@optum.com.
authors.forename: Shirley
authors.initials: S
authors.lastname: Musich
authors.affiliation: Formerly of Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Gulyas
authors.affiliation: Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.
authors.forename: Rifky
authors.initials: R
authors.lastname: Tkatch
authors.affiliation: Medicare & Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN 55440, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Cempellin
authors.affiliation: Advanced Analytics, Optum, 400 Capital Blvd, Rocky Hill, CT 06067, USA.
authors.forename: Gandhi R
authors.initials: GR
authors.lastname: Bhattarai
authors.affiliation: Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Hawkins
authors.affiliation: AARP Services, Inc., 601 E. Street, N.W., Washington, DC 20049, USA.
authors.forename: Charlotte S
authors.initials: CS
authors.lastname: Yeh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005102:Health Expenditures; D057220:Health Literacy / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D006278:Medicare; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D014481:United States
keywords: Health literacy; Medicare; Medicare supplement; Medigap; Older adults; Patient satisfaction