Readability of discharge summaries: With what level of information are we dismissing our patients?

Asad J. Choudhry, Yaser M.K. Baghdadi, Amy E. Wagie, Elizabeth B. Habermann, Stephanie F. Heller, Donald H. Jenkins, Daniel C. Cullinane, Martin D. Zielinski

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Background We assessed the health literacy of trauma discharge summaries and hypothesize that they are written at higher-than-recommended grade levels. Methods The Flesch-Kincaid grade level (FKGL) and Flesch reading ease scores (FRES), 2 universally accepted scales for evaluating readability of medical information, were used. Results A total of 497 patients were included. The mean patient age was 56 ± 22 years. Average FKGL and FRES were 10 ± 1 and 44 ± 7, including 132 summaries classified as very or fairly difficult to read. A total of 204 (65%) patients had functional reading skills at grade levels below the FKGL of their dismissal note; only 74 patients (24%) had the reading skills to adequately comprehend their dismissal summary. Total 30-day readmissions were 40, 65% of whom were patients with inadequate literacy for dismissal summary comprehension. Conclusions Patient discharge notes are written at too advanced of an educational level. To ensure patient comprehension, dismissal notes should be rewritten to a 6th-grade level.

Original languageEnglish (US)
Pages (from-to)631-636
Number of pages6
JournalAmerican journal of surgery
Issue number3
StatePublished - Mar 1 2016


  • Educational disparities
  • Flesch-Kincaid grade level
  • Health literacy
  • Readability
  • Trauma readmissions

ASJC Scopus subject areas

  • Surgery


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