Consumer competencies and the use of comparative quality information: it isn't just about literacy

Med Care Res Rev. 2007 Aug;64(4):379-94. doi: 10.1177/1077558707301630.


While consumers are increasingly expected to use complex health care information to make informed decisions, it is unclear how many have the skills to do so. In this investigation we examine health literacy, numeracy, and patient activation, assessing the contribution of each to the comprehension of comparative health care performance reports and their use in making an informed choice. A convenience sample of 303 employed-age adults participated in the study. The findings indicate that numeracy skill is the strongest predictor of comprehension, followed by health literacy. Higher activation helps those low in literacy and numeracy compensate for their lower skills and achieve higher levels of comprehension. In addition, making good choices, when trade-offs are necessary, is related to activation separate from comprehension. This is important as many real-life choices involve trade-offs. Results indicate that choice is not just about literacy or comprehension, it also has to do with activation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Benchmarking / statistics & numerical data*
  • Choice Behavior*
  • Comprehension*
  • Computer Literacy
  • Consumer Behavior / statistics & numerical data*
  • Consumer Health Information / statistics & numerical data*
  • Data Display
  • Educational Status*
  • Hospitals / standards*
  • Hospitals / statistics & numerical data
  • Humans
  • Mathematics
  • Middle Aged
  • Quality Indicators, Health Care / statistics & numerical data
  • Risk Assessment