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

Table 6 Unadjusted 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 regression

	Appraisal of health information (n = 1638)	Ability to actively engage with healthcare providers (n = 1629)	Navigating the healthcare system (n = 1639)	Ability to find good health information (n = 1629)	Understanding health information well enough to know what to do (n = 1636)
	OR (95% CI)^a	OR (95% CI)^a	OR (95% CI)^a	OR (95% CI)^a	OR (95% CI)^a
Total effect (education and HLQ)	0.78 (0.66; 0.92)**	0.78 (0.66; 0.92)**	0.76 (0.65; 0.89)**	0.77 (0.66; 0.91)**	0.77 (0.65; 0.90)**
Direct effect (education)	0.76 (0.65; 0.90)**	0.81 (0.68; 0.95)*	0.79 (0.67; 0.93)**	0.82 (0.69; 0.97)*	0.81 (0.68; 0.96)*
Indirect effect (HLQ)	1.02 (1.00; 1.04)*	0.97 (0.94; 1.00)*	0.97 (0.94; 1.00)*	0.94 (0.90; 0.98)**	0.95 (0.90; 1.00)*
Confounding ratio (total effect/direct effect)	0.92	1.16	1.14	1.30	1.24
Confounding percentage (% of model affect attributable to mediator)	−8.90%	13.78%	12.27%	22.88%	19.65%
Pseudo R square ^b	0.01	0.01	0.01	0.01	0.01

^a P-value * < 0.05, ** < 0.01, *** < 0.001, significant results printed in bold
^b According to McFadden method [51]

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