Determinants of health literacy and it's effects on patient outcomes: A stuy on patients admitted to cardiology polyclinics of a hospital

Health literacy is important because there is consistent evidence indicating an association between individual health literacy and patient outcomes. The aim of this research is to measure the health literacy levels of patients who have admitted to the cardiology polyclinic of a university hospital in Ankara and to determine the patient characteristics affecting their health literacy and to determine the association between health literacy level and patient outcomes and to show the effect of health literacy on patient outcomes. The European Health Literacy Survey (HLS-EU) developed by the European Health Literacy Survey Consortium (2012) was used to determine the level of health literacy of patients. The HLS-EU consists of 47 items. In the study, 537 patients were identified by quota sampling and 530 patients who had sufficient valid answers for health literacy index calculations were included in the analysis of health literacy index score calculations. Heath literacy indexes consist of the general health literacy index, health literacy domain indexes (three), health information process indexes (four), and 12 sub-dimension index, which is combination of these indexes. The alpha coefficients of these health literacy indexes were between 0,821-0,986 and were highly reliable. The average general health literacy index score of the patients was 31,3±10,3 out of 50. When the patients were classified according to general health literacy index score; approximately 2/5 (41.9%) of the patients had sufficient or excellent health literacy level, and 3/5 (58.1%) had insufficient or limited health literacy level. Patients who had higher educational level, had higher household income, were living in provincial center, had higher social status, were working and were students had higher health literacy index score averages and health literacy levels. According to the result of multiple regression analysis, in existence of the other variables, the level of health literacy index score and health literacy level of patients who female, living in urban centers, higher education level, household income and social status were found to be higher. In this study it was found that health literacy was closely related to health behaviors and health risks, health status, health care use and patient outcomes related to satisfaction. At the end of the study, it was suggested to develop health literacy skills of patients with low health literacy levels and thus to raise awareness among hospital management, health workers, patient relatives and all segments of society; it was also suggested that the overall health literacy skills of the entire community, particularly the patients, should be promoted, that the community and the patients should be more involved in the health care process, and that patients should take more responsibility for the management of their illnesses, especially chronic illnesses. Keywords Health Literacy, Health Behaviors, Health Risks, Health Care Use, Health Status, Satisfaction, Patient Outcome, Cardiology, Heart Diseases