Mediating Role of Health Literacy in Relationship Between Frailty and Medical Costs in Community-Dwelling Older Adults
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Source
2.3. Measurements
2.3.1. General Characteristics Variables
2.3.2. Frailty
2.3.3. Medical Costs
2.3.4. Health Literacy
2.4. Data Analysis
3. Results
3.1. Characteristics of Participants
3.2. Frailty Based on Participants’ Characteristics
3.3. Health Literacy Based on Participants’ Characteristics
3.4. Medical Cost Based on Participants’ Characteristics
3.5. Correlations Among Frailty, Health Literacy, and Medical Cost
3.6. Mediating Effect of Health Literacy on the Relationship Between Frailty and Medical Cost
4. Discussion
5. Conclusions and Recommendations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | n (%) | Frailty | Health Literacy | Medical Cost † | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
M ± SD | F or t | p | M ± SD | F or t | p | M ± SD | F or t | p | ||||
Total | 1538 | (100.0) | 1.89 ± 0.55 | 8.59 ± 2.62 | 1,605,633 ± 2,761,270 | |||||||
Gender | 7.01 | 0.008 | 143.16 | <0.001 | 0.91 | 0.340 | ||||||
Male | 940 | (61.1) | 1.91 ± 0.51 | 9.20 ± 2.41 | 1,659,234 ± 2,899,373 | |||||||
Female | 598 | (38.9) | 1.84 ± 0.60 | 7.63 ± 2.66 | 1,521,377 ± 2,529,062 | |||||||
Age | 37.82 | <0.001 | 33.68 | <0.001 | 0.26 | 0.769 | ||||||
70–75 | 779 | (50.7) | 1.79 ± 0.52 | 9.04 ± 2.50 | 1,555,945 ± 3,013,001 | |||||||
76–80 | 524 | (34.1) | 1.91 ± 0.54 | 8.38 ± 2.58 | 1,648,467 ± 2,563,113 | |||||||
81–84 | 235 | (15.3) | 2.13 ± 0.57 | 7.54 ± 2.76 | 1,674,833 ± 2,279,902 | |||||||
Spouse | 00.00 | 0.957 | 101.62 | <0.001 | 2.14 | 0.144 | ||||||
Partnered | 1123 | (73.0) | 1.89 ± 0.53 | 8.98 ± 2.50 | 1,543,073 ± 2,789,976 | |||||||
Single | 415 | (27.0) | 1.88 ± 0.58 | 7.51 ± 2.64 | 1,774,922 ± 2,678,023 | |||||||
Educational level | 5.27 | 0.001 | 137.25 | <0.001 | 1.67 | 0.173 | ||||||
≤Elementary | 606 | (39.4) | 1.95 ± 0.56 | 7.18 ± 2.53 | 1,799,380 ± 2,947,919 | |||||||
Middle school | 229 | (14.9) | 1.85 ± 0.56 | 8.71 ± 2.35 | 1,470,268 ± 2,350,892 | |||||||
High school | 338 | (22.0) | 1.84 ± 0.54 | 9.41 ± 2.24 | 1,455,690 ± 2,295,473 | |||||||
≥College | 365 | (23.7) | 1.84 ± 0.51 | 10.07 ± 2.05 | 1,507,738 ± 3,050,667 | |||||||
Economic activity | 0.11 | 0.742 | 0.38 | 0.540 | 3.44 | 0.064 | ||||||
In employment | 384 | (25.0) | 1.88 ± 0.53 | 8.66 ± 2.65 | 1,379,337 ± 1,924,842 | |||||||
Unemployed | 1154 | (75.0) | 1.89 ± 0.55 | 8.56 ± 2.61 | 1,680,934 ± 2,985,045 | |||||||
Household monthly income * | 8.67 | <0.001 | 67.94 | <0.001 | 0.15 | 0.931 | ||||||
<100 | 600 | (39.0) | 1.97 ± 0.57 | 7.57 ± 2.73 | 1,604,381 ± 2,350,272 | |||||||
100–200 | 376 | (24.5) | 1.87 ± 0.51 | 8.67 ± 2.43 | 1,657,219 ± 2,900,015 | |||||||
200–300 | 245 | (15.9) | 1.82 ± 0.55 | 9.35 ± 2.24 | 1,636,073 ± 3,327,312 | |||||||
≥300 | 317 | (20.6) | 1.80 ± 0.51 | 9.81 ± 2.13 | 1,523,288 ± 2,841,709 | |||||||
Self-rated health status | 79.32 | <0.001 | 147.66 | <0.001 | 16.97 | <0.001 | ||||||
Healthy | 1122 | (73.0) | 1.81 ± 0.52 | 9.06 ± 2.47 | 1,429,906 ± 2,598,534 | |||||||
Unhealthy | 416 | (27.1) | 2.08 ± 0.56 | 7.31 ± 2.59 | 2,079,588 ± 3,112,941 | |||||||
Smoking | 1.54 | 0.214 | 28.31 | <0.001 | 0.94 | 0.393 | ||||||
Non-smoker | 763 | (49.6) | 1.87 ± 0.58 | 8.09 ± 2.71 | 1,586,646 ± 2,775,808 | |||||||
Ex-smoker | 668 | (43.4) | 1.90 ± 0.52 | 9.10 ± 2.40 | 1,677,585 ± 2,896,586 | |||||||
Smoker | 107 | (7.0) | 1.95 ± 0.46 | 8.91 ± 2.66 | 1,291,830 ± 1,495,875 | |||||||
Drinking | 4.09 | 0.003 | 7.22 | <0.001 | 6.21 | <0.001 | ||||||
Non-drinking | 470 | (30.6) | 1.95 ± 0.56 | 8.25 ± 2.66 | 2,065,895 ± 3,481,819 | |||||||
≤1 time/month | 450 | (29.3) | 1.86 ± 0.56 | 8.39 ± 2.58 | 1,574,646 ± 2,258,369 | |||||||
2–4 times/month | 241 | (15.7) | 1.79 ± 0.53 | 9.17 ± 2.55 | 1,491,211 ± 3,404,519 | |||||||
2–3 times/week | 209 | (13.6) | 1.88 ± 0.54 | 9.03 ± 2.52 | 1,065,710 ± 1,182,165 | |||||||
≥4 times/week | 168 | (10.9) | 1.92 ± 0.48 | 8.67 ± 2.67 | 1,236,828 ± 1,702,256 |
Variable | Frailty | Health Literacy | Medical Cost |
---|---|---|---|
r (p) | r (p) | r (p) | |
Frailty | 1 | ||
Health literacy | −0.27 (<0.001) | 1 | |
Medical cost | 0.15 (<0.001) | −0.07 (0.008) | 1 |
Steps | Direction | β (p) | t | R2 | Adj. R2 | F (p) |
---|---|---|---|---|---|---|
Step 1 | Frailty → Health literacy | −0.53 (<0.001) | −4.89 | 0.320 | 0.316 | 79.73 (<0.001) |
Step 2 | Frailty → Medical cost | 0.26 (0.001) | 0.040 | 0.037 | 10.73 (0.001) | |
Step 3 | Frailty, Health literacy → Medical cost | 0.044 | 0.040 | |||
Health literacy → Medical cost | −0.04 (0.046) | 3.96 (0.047) | ||||
Frailty → Medical cost | 0.24 (0.002) | 9.34 (0.002) |
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Kim, H.-S.; Kim, J. Mediating Role of Health Literacy in Relationship Between Frailty and Medical Costs in Community-Dwelling Older Adults. Healthcare 2025, 13, 1331. https://doi.org/10.3390/healthcare13111331
Kim H-S, Kim J. Mediating Role of Health Literacy in Relationship Between Frailty and Medical Costs in Community-Dwelling Older Adults. Healthcare. 2025; 13(11):1331. https://doi.org/10.3390/healthcare13111331
Chicago/Turabian StyleKim, Hee-Sun, and Jinhee Kim. 2025. "Mediating Role of Health Literacy in Relationship Between Frailty and Medical Costs in Community-Dwelling Older Adults" Healthcare 13, no. 11: 1331. https://doi.org/10.3390/healthcare13111331
APA StyleKim, H.-S., & Kim, J. (2025). Mediating Role of Health Literacy in Relationship Between Frailty and Medical Costs in Community-Dwelling Older Adults. Healthcare, 13(11), 1331. https://doi.org/10.3390/healthcare13111331