Among more than 1,200 patients who underwent major abdominal surgery, a lower health literacy level was associated with a longer hospital length of stay, according to a study published by JAMA Surgery.

Health literacy is defined as an individual’s ability to obtain, process, and understand health information to make informed decisions and function effectively in the healthcare environment. There is a lack of data on the role of health literacy on postoperative outcomes. Kamran Idrees, MD, MSCI, of Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues examined the association of health literacy with postoperative outcomes in 1,239 patients who underwent elective gastric, colorectal, liver, or pancreatic surgery for both benign and malignant disease. Health literacy levels were assessed using the Brief Health Literacy Screen, a validated tool that was administered by nursing staff on hospital admission. The median educational attainment of the patients was 13 years.

The researchers found that lower health literacy levels were associated with an increased hospital length of stay following surgery, such that patients with low health literacy levels spent an additional median of one day in the hospital compared with those with a high health literacy level. Lower health literacy was not significantly associated with increased rates of 30-day emergency department visits or 90-day hospital readmissions.

The authors “suggest that surgical patients with low health literacy levels require additional time and resources for discharge teaching and instruction (e.g., management of surgically placed drains, wound care management, dietary changes), arranging home-health needs, and managing general anxiety regarding self-care during surgical disability once out of the hospital.”

Several limitations of the study are noted in the article.