Public Health Literacy and Emergency Department Utilization in Saudi Arabia: A Cross-Sectional Study

Muna Aljahany,1 Rasha Doumi,2 Ruba Adel Alhuthail,2 Hind Yahiya Alshangiti,2 Reem Abdullah Alsugair,2 Laila Salah Aldokhail,2 Lujain Hatim Aljohani,2 Nuwayyir Abdullah Alqasimi,2 Enar Mohammed Alotaibi,2 Lujain Mohamed Alaradi,2 Norah Abdulaziz Alabdullah,2 Nadeen Saad Alkelabi,2 Nouran A Aleyeidi,2 Amel Fayed2 1Department of Internal Medicine, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Rasha Doumi, Family and Community Medicine Department, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia, Tel +00966505813784, Email [email protected]: Health literacy (HL) is the degree in which individuals are able to access, comprehend, and use publicly available health resources and services. A previous study was done in the Kingdom of Saudi Arabia (KSA) assessing the prevalence of HL, the study shows that almost half of KSA residents had limited HL. Most studies that show the level of HL and its relationship to emergency department (ED) utilization were conducted outside KSA. This study aims to assess the association between HL and utilization of ED services and to estimate the prevalence, factors, and outcomes of low HL in KSA.Patients and methods: A cross-sectional study was conducted among 903 participants in KSA over a period of 2 months (April and May 2023) using an online survey. Participants were asked about sociodemographic characteristics (age, sex, nationality, marital status, education, work status, income), associated factors (chronic diseases, psychiatric disorders, Covid-19 infection, Covid-19 vaccination, ED visits), and Health Literacy (read, access, understand, evaluation, decision). A health literacy instrument for adults (HELIA), which consists of the previously mentioned five subscales, was used to estimate the level of HL and its association with the risk factors.Results: Almost 529 (58.58%) and 374 (41.42%) had limited HL and adequate HL, respectively. Participants with limited HL were mostly aged 35– 45 years (61.7%), men (p 30 thousand riyals (55.6%, p < 0.05), were previously infected with COVID-19 (43%), and did not visit ED in the preceding year (42.3%).Conclusion: A high prevalence of low HL among KSA residents was observed. There was no significant difference in ED utilization between participants who had adequate and limited HL.Keywords: health literacy instrument for adults, emergency department utilization, COVID-1