Jo Ellins Picker Institute
Presented at Information advice and advocacy for patients March 2006
The problems of the patient choice agenda
Health literacy and the widening of inequalities through patient choice
What needs to be done?
The problems of patient choice
Market-based choice inevitably creates winners and losers
Patients want choice, but not of the type they are being offered
There will be a net reduction in choice if wards/departments are forced to close
If health literacy isn’t tackled, choice will widen health inequalities
What is health literacy?
A range of skills needed to access, understand and act upon health information
Skills include:
- health knowledge
- verbal and written communication skills
- ability to analyse and evaluate health information
Not just basic skills in a health context
Who is affected?
Estimated that nearly half the American adult population (90 million) have low health literacy
Disproportionately affects:
- economically disadvantaged
- ethnic minorities
- elderly
- learning disabled
- long-term ill
Using information to make choices
Both the choices patients face and the information needed to make them are highly complex. Informed choice will effectively be restricted to those with sufficient health literacy . The best quality healthcare will go to people least in need of it
South Birmingham PCT ‘Choosing your hospital’
The American experience
Greene and colleagues examined older people’s ability to choose between competing health plans
Health literacy directly associated with people’s confidence to make decisions about their care and their ability to use comparative information to do so effectively
What needs to be done?
Building health literacy should be made a public health priority
A significant improvement in the accessibility and usability of patient information to support choice
Create a coherent support and advocacy framework – eg patient care advisors
Give patients choices that are meaningful to them