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Table 7 Adjusted odds ratios (OR) for direct, indirect and total effects for the association between education and out-of-hours primary care use, mediated through health literacy, using the KHB method with logistic regressiona

From: The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study

  Appraisal of health information (n = 1612) Ability to actively engage with healthcare providers (n = 1603) Navigating the healthcare system (n = 1612) Ability to find good health information (n = 1603) Understanding health information well enough to know what to do (n = 1609)
  OR (95% CI)b OR (95% CI)b OR (95% CI)b OR (95% CI)b OR (95% CI)b
Total effect (education and HLQ) 0.82 (0.69; 0.98)* 0.82 (0.69; 0.97)* 0.80 (0.68; 0.95)* 0.82 (0.69; 0.97)* 0.81 (0.69; 0.96)*
Direct effect (education) 0.81 (0.68; 0.96)* 0.85 (0.71; 1.01) 0.83 (0.70; 0.98)* 0.85 (0.72; 1.01) 0.85 (0.71; 1.01)
Indirect effect (HLQ) 1.02 (1.00; 1.04)* 0.97 (0.94; 1.00) 0.97 (0.95; 1.00)* 0.96 (0.92; 0.99)* 0.96 (0.92; 1.00)
Confounding ratio (total effect/direct effect) 0.91 1.18 1.13 1.27 1.25
Confounding percentage (% of model affect attributable to mediator) −9.79% 14.92% 11.83% 21.07% 19.91%
Pseudo R square c 0.02 0.02 0.02 0.02 0.02
  1. a All models are adjusted for age (continuous), sex (ref male), household status (ref living alone), number of chronic diseases (ref one chronic disease), and illness duration
  2. b P-value * < .05, ** < .01, *** < .001, significant results printed in bold
  3. c According to McFadden method [51]