The influence of health literacy on emergency department utilization and hospitalizations in adolescents with sickle cell disease

Public Health Nurs. 2019 Nov;36(6):765-771. doi: 10.1111/phn.12643. Epub 2019 Aug 11.


Objective: Healthcare spending in the US is $3.2 trillion. $1.1 trillion is attributed to hospital care, including emergency department (ED) visits and hospitalizations. There is a relationship between ED utilization, hospitalizations, and health literacy in the general population. Health literacy may play a role in frequent ED visits and hospitalizations in patients with sickle cell disease (SCD). The purpose of this paper is to describe the relationship among health literacy levels, annual hospital encounters, annual clinic visits, annual ED visits, and annual hospitalizations in 134 Black, non-Hispanic adolescents aged 10-19 years with SCD.

Design: This is a cross-sectional, descriptive correlational study evaluating facilitators and barriers to health literacy and clinical outcomes in adolescents with SCD.

Sample: Data were collected from 134 Black, non-Hispanic adolescents with SCD at a large, tertiary care center in Texas.

Measurements: The Newest Vital Sign and REALM-Teen health literacy instruments were used to evaluate health literacy.

Results: Contrasting previous studies evaluating the influence of health literacy on ED visits and hospitalizations in the general population, there were no significant relationships within this sample.

Conclusions: This study gives insight into future research to evaluate other potential influences on ED utilization and hospitalizations in pediatric patients with SCD.

Keywords: adolescents; emergency care; health literacy; literacy; sickle cell disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Health
  • African Americans
  • Ambulatory Care / statistics & numerical data*
  • Anemia, Sickle Cell / pathology
  • Anemia, Sickle Cell / therapy*
  • Child
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Literacy*
  • Health Status
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Texas