Health Literacy and Post-op Outcomes in Patients Undergoing Day Surgery

Albert B. Lowenfels, MD


November 16, 2018

In patients undergoing day surgery, is functional health literacy related to postoperative recovery and to health-related quality of life? The authors of a paper, published in JAMA Surgery, looked at healthcare literacy (defined as the ability to understand and follow written health instructions) as a predictor of recovery and health-related quality of life in a group of 704 Swedish patients 2 weeks after orthopedic, hand, general, and other types of surgery.[1]

Information was obtained using survey questionnaires. The quality of recovery, including such items as physical function and pain, was strongly related to overall healthcare literacy (P < .001) and to healthcare quality of life (P = .006).


The results of this study imply that ability to understand and act upon instructions given to patients following outpatient surgery should be an important determining factor in assessing a patient's suitability to undergo day (outpatient) surgery.

There are several potential problems with the study: About one third of patients originally contacted failed to enter the study, which introduces selection bias. Furthermore, the information was obtained by a Short Form (SF-36) Health Survey questionnaire, with no information available about the patient's level of education or income. In addition, the report has no information about support available to the patient after the operation. Was there a responsible person living with or available to the patient?

Despite these potential problems, the report implies that a patient's level of health literacy should be considered an important factor when being evaluated for outpatient surgery.

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