Exploring health literacy, transition readiness, and health care utilization in Medicaid chronically ill youth
| Autor: | Deena J. Chisolm, Hannah Keedy, Connor Grannis, Millie Dolce, Laura J. Chavez, Laura C. Hart, Jennifer Morack, Kelly J. Kelleher |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Transition to Adult Care Transition readiness Adolescent Health literacy Article 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Health care Medicine Humans 030212 general & internal medicine Child business.industry Medicaid digestive oral and skin physiology Public Health Environmental and Occupational Health Emergency department Patient Acceptance of Health Care United States Health Literacy Psychiatry and Mental health Healthcare utilization Accountable care Family medicine Pediatrics Perinatology and Child Health Ambulatory Chronic Disease business Emergency Service Hospital |
| Zdroj: | J Adolesc Health |
| Popis: | Youths with special healthcare needs face challenges transitioning from pediatric to adult health care. Understanding possible mechanisms contributing to poor healthcare transition could improve care. This study explores associations between health literacy (HL), transition readiness, and healthcare utilization.Youths with special healthcare needs aged 12-18 years were recruited from a Medicaid accountable care organization (2012-2017). Outcome measures included transition readiness (Transition Readiness Assessment Questionnaire), and healthcare utilization (any well-check, hospitalization, emergency department [ED] visit, or ambulatory sensitive condition ED visit). Multivariate regression analyses examined whether HL (adequate vs. inadequate) predicted outcomes, after adjusting for covariates. Models were then created to examine whether the effect of HL on healthcare utilization was mediated by transition readiness.Among 417 youths with special healthcare needs, 67.1% reported adequate HL. Relative to inadequate HL, teens with adequate HL had significantly higher average Transition Readiness Assessment Questionnaire-20 scores (β = .34, p.001). Controlling for covariates, HL was a significant predictor of having an ambulatory sensitive condition ED visit and having any ED visits neared significance. There was a positive transition readiness mediation effect on having an ED visit, with higher transition readiness being associated with higher odds of having any ED visit in the mediation analysis.HL is independently associated with higher transition readiness and lower ambulatory sensitive condition ED use, but pathways of action require further study. |
| Databáze: | OpenAIRE |
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