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The costs of limited health literacy: a systematic review
Klaus Eichler1, Simon Wieser, Urs Brügger
1Winterthur Institute of Health Economics (WIG), ZHAW Zurich University of Applied Sciences, Postfach 958, St. Georgenstrasse 70, 8401, Winterthur, Switzerland. eich@zhaw.ch
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.
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