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Patients' Bill of Rights Too Tough to Read
Date:3/27/2009

imore. "It looks like hospitals and states are not taking [reading level] into account [in patients' bill or rights], because they obviously far exceed the average reading level for most adults."

One of the problems is that there is no federal bill of rights. So, the researchers, led by Dr. Michael K. Paasche-Orlow, an associate professor of medicine at Boston University, assessed the readability of patients' bills of rights (PBOR) from across the country and compared them with the first such bill issued by the American Hospital Association in 1973. The AHA bill of rights included 12 themes -- among them, the right to confidentiality, the right to refuse treatment and to refuse participation in research. PBORs in individual states and hospitals were examined.

And the researchers found that:

  • Statutes in 23 states and at 240 hospitals required an average of two years of college to read and understand.
  • The documents also tended to be presented only in English, although there were some exceptions.
  • They covered an average of only seven of the 12 themes presented by the AHA

"Hospitals make every effort to communicate with patients in a clear and concise manner that can be understood by all," reads a reaction statement from the American Hospital Association. "This study highlights what we have long known: There are some major issues with low health literacy in this country. Health care and the associated laws and regulations are very complicated, and often cannot easily be explained to a patient at any literacy level."

But Paasche-Orlow offered a different view. "Legislatures should not be drafting documents for patients," he said. "Lawyers have certain type of expertise, but they frequently fail when it comes to patient information."

"These concepts really can be communicated in a much simpler fashion, and really should be," added Paasche-Orlow. "In nine states, the legislator
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