The costs of limited health literacy: a systematic review
Eichler, Klaus ; Wieser, Simon ; Brügger, Urs
In: International Journal of Public Health, 2009, vol. 54, no. 5, p. 313-324
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- Objectives: To summarize evidence about (1) the costs of limited health literacy (HL) and (2) the cost-effectiveness of interventions to improve limited HL. Methods: We performed a systematic review searching electronic databases and additional information resources. We included observational studies and interventional studies with HL-outcomes. We included populations at high risk for low HL and patients with (1) diabetes mellitus or (2) hyperlipidemia. Results: We retrieved 2,340 papers and included 10 studies for analysis. The prevalence of limited HL is considerable (range 34-59%). On the health system level, the additional costs of limited HL range from 3 to 5% of the total health care cost per year. On the patient level, the additional expenditures per year per person with limited HL compared to persons with adequate HL range from US $143 to 7,798. Data on the cost-effectiveness of interventions to improve limited HL are scarce. Conclusion: The costs of limited HL may be substantial, but few studies were retrieved and the results are heterogeneous