Effect of health literacy on hospital readmission among patients with heart failure: A protocol for systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Patients with heart failure have a high rate of health literacy deficiency, and their hospital readmission is a great burden. Whether health literacy affects hospital readmission remains controversial. OBJECTIVE: To investigate the impact of health literacy on hospital readmission among heart failure patients. METHOD: Relevant keywords were used to search for Chinese and English literature from Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Digital Journal of Wanfang Data, and Chinese BioMedical Literature Database. Newcastle-Ottawa Scale was used to assess the quality of the studies. Statistical analysis was performed using Stata 15.0, the fixed effect model was used to calculate the pooled effect estimate, and Begg's and Egger's tests were applied to assess the presence of publication bias. RESULTS: Nine studies, involving 4093 heart failure patients, were included in this study. The overall rate of inadequate health literacy was 40.3%. Among these articles, 6 were included in the meta-analysis to calculate the pooled effect. The results indicated that, when compared with patients with adequate health literacy, those with inadequate health literacy had a relative risk of hospital readmission of 1.01, which increased to 1.14 after adjusting for follow-up time, the result was not significant (P = .09). CONCLUSIONS: About 2 out of 5 heart failure patients had inadequate health literacy, and there was no statistical association between health literacy and hospital readmission among these patients. This finding should be carefully considered and confirmed in further studies.