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Illiteracy: The Silent Barrier to Health Care

Paul T. Kefalides, MD
Ann Intern Med. 1999;130(4_Part_1):333-336. doi:10.7326/0003-4819-130-4-199902161-00001
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Workers in the field of health communication are sounding a warning on patients' reading skills. Emerging literature on illiteracy and health care indicates that up to 50% of certain clinical populations may be unable to read and understand medical instructions. As health care moves from the hospital to the home, researchers and clinicians are becoming increasingly aware of the challenges presented by the large number of illiterate patients. Mistakes resulting from poor reading skills can lead to repeated hospitalizations and may be costing the health care industry billions of dollars. In response, a group of public health researchers propose that physicians use pictographs when instructing patients; others suggest devoting extra attention to some patients with substandard reading skills and multiple medical problems.

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illiteracy

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Grahic Jump Location
. Pictographs being developed for persons with HIV or AIDS. The patient is instructed to call the doctor if he or she has painless lumps or unexplained weight loss, fatigue, or rash. (Courtesy of Johns Hopkins Oncology Center)
Figure 1
Grahic Jump Location
Grahic Jump Location
Pictographs designed to improve the patient's recall of spoken medical instructions when used in combination with verbal instructions from health care workers. (Courtesy of Johns Hopkins Oncology Center)
Figure 2.
Grahic Jump Location

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