Exploring the barriers to the development of organizational health literacy in health institutions from the perspective of older patients: a mixed study

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Abstract
Background The 2020 national health literacy monitoring revealed that only 8.49% of individuals aged 65–69 years, a segment of the older population, possess adequate health literacy levels, indicating a low level in China. Studies have demonstrated that improving the organizational health literacy of healthcare institutions is a crucial approach to addressing low health literacy among older patients. Objective To assess the present status of organizational health literacy development within healthcare institutions as perceived by older patients, and to investigate the obstacles hindering such development. Design: A mixed-methods approach was employed to investigate both the current status and barriers to the establishment of organizational health literacy within two healthcare institutions. Participants: Participants included older individuals aged over 60, clinical staff, and managerial personnel from these two health institutions. Methods A survey comprising a questionnaire (n = 178) was administered to older patients to evaluate the establishment of organizational health literacy within healthcare institutions from their viewpoint. Furthermore, interviews (n = 22) were conducted with administrative staff, clinical personnel, and older patients to identify barriers hindering the development of organizational health literacy within healthcare institutions. Results Quantitative research indicates that health institutions have been less accommodating to the requirements of older patients, with health information dissemination and communication emerging as the weakest areas. Qualitative investigations revealed three key influencing factors: patient-related factors, including physiological and cognitive decline, as well as low educational attainment among older patients; organizational factors, including inadequate clinical staff numbers, deficient long-term systematic training, and a digital divide resulting from health institutions’ digital advancements; and policy-related factors indicating a lack of regulations governing the establishment of organizational health literacy within healthcare institutions. Conclusions This research utilized the social-ecological model as its theoretical underpinning and employed a combination of methodologies to examine the current state and hurdles in establishing organizational health literacy within healthcare institutions. Future studies may consider devising comprehensive interventions based on the barriers identified herein, aiming to enhance organizational health literacy within healthcare institutions, meet the needs of older patients, and promote active aging.

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