Relationship between Health Literacy and Health Status Among Participants in a Congestive Heart Failure Disease Management Program

To better understand the relationship between self reported health literacy and health status among Medicare enrollees with an AARP® Medicare Supplement Insurance (i.e. Medigap) plan insured by UnitedHealthcare Insurance Company (or UnitedHealthcare Insurance Company of New York), we surveyed 649 Medigap members in a Heart Failure (HF) disease management pilot program. The surveys assessed the members' health status, health literacy, satisfaction with the HF program, and perceptions of how the HF program helped them manage their health. 410 members (65.8%) responded to the survey. Nearly two-thirds (64.3%) of the respondents were ‘extremely' or ‘quite a bit' confident in filling out medical forms by themselves (a measure of health literacy), while the rest were either ‘somewhat' (23%), ‘a little bit' (5%), or ‘not at all' (8%) confident in filling out forms by themselves. Only about 10% reported ‘excellent' or ‘very good' health status, while 44% reported ‘good' and 46% ‘fair' or ‘poor' health status. The health status responses were stratified by responses to confidence in filling out medical forms to establish a relationship. As a result, 84% of those in ‘excellent' or ‘very good' health were ‘extremely' or ‘quite a bit' confident filling out medical forms. Meanwhile, 66% of those in ‘good' and 58% of those in ‘fair' or ‘poor' health were ‘extremely' or ‘quite a bit' confident filling out medical forms, respectively (P<0.05; Chi-Square test). Health literacy appears to decline with health status. This is problematic, as those in the poorest of health often require the most extensive care.