Health literacy affects likelihood of radiology testing in the pediatric emergency department. J Pediatr 2015 Apr;166(4):1037-41.e1
Date
01/18/2015Pubmed ID
25596100Pubmed Central ID
PMC4380861DOI
10.1016/j.jpeds.2014.12.009Scopus ID
2-s2.0-84933279045 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
OBJECTIVE: To test the hypothesis that the effect of race/ethnicity on decreased radiologic testing in the pediatric emergency department (ED) varies by caregiver health literacy.
STUDY DESIGN: This was a secondary analysis of a cross-sectional study of caregivers accompanying children ≤ 12 years to a pediatric ED. Caregiver health literacy was measured using the Newest Vital Sign. A blinded chart review determined whether radiologic testing was utilized. Bivariate and multivariate analyses, adjusting for ED triage level, child insurance, and chronic illness were used to determine the relationship between race/ethnicity, health literacy, and radiologic testing. Stratified analyses by caregiver health literacy were conducted.
RESULTS: Five hundred four caregivers participated; the median age was 31 years, 47% were white, 37% black, 10% Hispanic, and 49% had low health literacy. Black race and low health literacy were associated with less radiologic testing (P < .01). In stratified analysis, minority race was associated with less radiologic testing only if a caregiver had low health literacy (aOR 0.5; 95% CI 0.3-0.9), and no difference existed in those with adequate health literacy (aOR 0.7; 95% CI 0.4-1.3).
CONCLUSIONS: Caregiver low health literacy modifies whether minority race/ethnicity is associated with decreased radiologic testing, with only children of minority caregivers with low health literacy receiving fewer radiologic studies. Future interventions to eliminate disparities in healthcare resource utilization should consider health literacy as a mutable factor.
Author List
Morrison AK, Brousseau DC, Brazauskas R, Levas MNAuthors
Ruta Brazauskas PhD Associate Professor in the Institute for Health and Equity department at Medical College of WisconsinMichael Levas MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Caregivers
Child
Child Health Services
Cross-Sectional Studies
Emergency Service, Hospital
Female
Health Education
Health Literacy
Health Services Accessibility
Humans
Male
Middle Aged
Radiology
Socioeconomic Factors
Triage
Young Adult
