Key result
Health literacy assessment linked to better 30-day readmission prediction than LACE+ alone.
Why the study?
The utility of health literacy and biopsychosocial determinants in predicting 30-day readmission risk compared to existing calculators was unclear.
Does an assessment battery capturing health literacy and biopsychosocial determinants of health improve prediction of 30-day readmission compared to LACE+ alone in general medicine inpatients?
Observational (n=537)
No
Does an assessment battery capturing health literacy and biopsychosocial determinants of health improve prediction of 30-day readmission compared to LACE+ alone in general medicine inpatients?
p-value: p=0.013
Incorporating health literacy and biopsychosocial determinant assessments significantly improves 30-day readmission risk stratification compared to the LACE+ calculator alone.
Health literacy assessment may improve readmission prediction beyond LACE+; hypothesis-generating and requires prospective validation before practice change.
Our objective was to assess the utility of an assessment battery capturing health literacy (HL) and biopsychosocial determinants of health in predicting 30-day readmission in comparison to a currently well-adopted readmission risk calculator. We also sought to capture the distribution of inpatient HL, with emphasis on inadequate and marginal HL (an intermediate HL level). A prospective observational study was conducted to obtain HL and biopsychosocial data on general medicine inpatients admitted to the UCLA health system. Five hundred thirty-seven subjects were tracked prospectively for 30-day readmission after index hospitalization. HL was significantly better at predicting readmission compared to LACE + (Length, admission acuity, comorbidities, emergency room visits) alone ( P = .013). A multivariate model including education, insurance, and language comfort was a strong predictor of adequate HL ( P < .001). In conclusion, HL offered significant improvement in risk stratification in comparison to LACE + alone. Patients with marginal HL were high-risk, albeit difficult to characterize. Incorporating robust HL and biopsychosocial determinant assessments may allow hospital systems to allocate educational resources towards at-risk patients, thereby mitigating readmission risk.
No takes yet. Share an insight, caveat, or question.
Deshpande et al. (2022) conducted an observational in General medicine inpatients (n=537). Health literacy (HL) and biopsychosocial determinants assessment vs. LACE+ readmission risk calculator alone was evaluated on 30-day readmission (p=0.013). Health literacy assessment was significantly better at predicting 30-day readmission compared to the LACE+ risk calculator alone (P=0.013).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: