INADEQUATE FUNCTIONAL HEALTH LITERACY AMONG PATIENTS AT 2 PUBLIC HOSPITALS

Objective.-To determine the ability of patients to complete successful ly basic reading and numeracy tasks required to function adequately in the health care setting, Design.-Cross-sectional survey. Setting.-Two urban, public hospitals. Patients.-A total of 2659 predominantly indi gent and minority patients, 1892 English-speaking and 767 Spanish-spea king, presenting for acute care. Main Outcome Measure.-Functional heal th literacy as measured by the Test of Functional Health Literacy in A dults (TOFHLA), an instrument that measures ability to read and unders tand medical instructions and health care information presented in pro se passages and passages containing numerical information leg, prescri ption bottle labels and appointment slips). Results.-A high proportion of patients were unable to read and understand written basic medical instructions. Of 2659 patients, 1106 (41.6%) were unable to comprehend directions for taking medication on an empty stomach, 691 (26%) were unable to understand information regarding when a next appointment is scheduled, and 1582 (59.5%) could not understand a standard informed c onsent document. A total of 665 (35.1%) of 1892 English-speaking patie nts and 473 (61.7%) of 767 Spanish-speaking patients had inadequate or marginal functional health literacy. The prevalence of inadequate or marginal functional health literacy among the elderly (age greater tha n or equal to 60 years) was 81.3% (187/230) for English-speaking patie nts and 82.6% (57/69) for Spanish-speaking patients, and was significa ntly higher (P<.001) than in younger patients. Conclusions.-Many patie nts at our institutions cannot perform the basic reading tasks require d to function in the health care environment. Inadequate health litera cy may be an important barrier to patients' understanding of their dia gnoses and treatments, and to receiving high-quality care.