Research rundown: poor health literacy can lead to more emergency department visits

Oct 3, 2017
Research rundown: poor health literacy can lead to more emergency department visits

The claim

Poor health literacy increases the risk of preventable emergency department (ED) visits.

The science

Health literacy is defined as the degree to which someone can obtain, process, and understand basic health information and services.1

Poor health literacy is particularly an issue when it comes to communicating complex scientific information to patients. In the US, the average adult American reads at an 8th– or 9th-grade level, while most health materials are written at a 10th-grade reading level or higher.2,3

The discrepancy between reading levels in patients and the level of their health materials can lead to a poor understanding of vital health information, including how to access medicines or how to manage a treatment regimen.

Poor public health literacy also affects wider society by contributing to high costs and inefficiencies within the US healthcare system.4

The method

Researchers at the Society for Academic Emergency Medicine determined the health literacy of 1,201 Americans and compared these findings with the numbers of potentially preventable ED visits and the numbers of treat-and-release visits for each participant.

The levels of health literacy were determined through structured interviews and electronic record reviews. Age, gender, race, employment, payer, marital status, health and co-morbidities were all recorded for each patient.

The results

A total of 394 participants were determined to have limited health literacy.

Of 4,444 total ED visits, 423 were potentially preventable. Of these, 260 led to hospital admission and 163 were treat-and-release.

Those participants with poor health literacy had experienced 2.3 times the number of potentially preventable ED visits, 1.4 times the number of treat-and-release visits, and 1.9 times the number of total preventable ED visits compared to those with good health literacy.

The potential

Improving the health literacy of the general population is a long-term goal for the healthcare industry. As the results of this study suggest, by doing so, the number of people who visit EDs could decline, both for visits that are legitimately needed and those that are preventable.

The authors of the study suggest that better health literacy could be promoted by providing universal literacy-sensitive materials in EDs, thereby reducing the burden of potentially preventable ED visits on patients and the healthcare system.

As a member of the healthcare community, Astellas is working to improve health literacy by simplifying the information it provides to its patients. Read about our new health literacy guidelines here.

The source

Meenakshi Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, and Donna L. Carden. The Association of Health Literacy with Preventable ED Visits: A CrossSectional Study. Academic Emergency Medicine (2017).


  1. S. Department of Health and Human Services. Quick Guide to Health Literacy. (accessed September 15, 2017)
  2. Safeer RS, Keenan J. Health literacy: the gap between physicians and patients. Am Fam Phys 2005; 72:463-468.
  3. The literacy problem. Harvard University website: (accessed September 15, 2017)
  4. From Margin to Mainstream: The Top 5 Reasons Health Literacy Should be Healthcare’s Next Priority. Elsevier website: (accessed September 15, 2017)
Research rundown: poor health literacy can lead to more emergency department visits

Astellas Patient Advocacy is a function within Corporate Affairs at Astellas that focuses on creating, building and maintaining third-party relationships. We serve as a conduit between Astellas and external stakeholders to help improve patient outcomes, improve access issues and address patients’ unmet needs head on.

Leave a Reply