Health literacy and outpatient physician visits in Switzerland

Abstract

Health literacy has been identified as an important contributor to health inequalities in industrialised countries (Kickbusch, 2002). Health literacy can be defined as “the capacity to obtain, interpret and understand basic health information and services and the competence to use such information and services to enhance health” (United States Department of Health and Human Services, 2000). Limited health literacy is associated with poor health (DeWalt et al., 2004) and high health care cost (Eichler et al., 2009). One possible explanation for these disparities is different health service utilisation. It has been shown that people with limited health literacy use diagnostic interventions less frequently (Bennett et al., 2009; Garbers, 2004; Guerra et al., 2005; Peterson et al., 2007; White et al., 2008), have lower immunisation rates (Bennett et al., 2009; Howard et al., 2005; Scott et al., 2002; Sudore et al., 2006), are more likely to be admitted to emergency departments (Cho et al., 2008; Howard et al., 2005; Murray et al., 2009), and have more inpatient hospital stays (Cho et al., 2008; DeWalt et al., 2004; Hope et al., 2004; Paasche-Orlow et al., 2005). Outpatient physician visits, however, are not well covered in the literature (Baker et al., 2004) and most studies analysing service utilisation are limited to very specific patient groups. Our study investigates the association between health literacy and outpatient physician visits based on data from a Swiss population survey