Costs of low health literacy

Low health literacy is expensive

Low health literacy is expensive to individuals, to healthcare providers and to society. Modelling by American authors estimated that low health literacy costs the US economy (in the form of additional healthcare required and days of sick pay) between $106 billion and $238 annually, representing 7-17% of all personal healthcare expenditure. It was calculated that the knock-on effect of low health literacy, for future generations, raised the total costs to US $1.6-$3.6 trillion.

Swiss authors undertook a detailed review of cost-calculation studies on low health literacy in American and Swiss populations, concluding that low health literacy raised total national healthcare provider budgets by an extra 3-5%, and increased costs to patients themselves by as much as US $7798. Turning these figures into real values, in the UK for instance, an additional 3-5% to the NHS budget equalled £2.87-£4.78 billion in 2013-2014.

As astonishing as some of these numbers may seem, they also may be too small. Other economic costs can probably be associated with low health literacy but are harder to calculate, such as lost income tax revenue due to lost years of productive employment.

Cost effectiveness of interventions

Individual interventions that targeted aspects of low health literacy have also been shown to be cost-effective. Examples are:

  • A low-literacy approach to providing information about cancer screening showed gross savings per patient of > US $236 3.
  • A program to teach low-income parents how to treat common childhood illnesses at home resulted in significant decreases in emergency room visits, days off school and days off work for carers 4.
  • A computer-delivered intervention on medication adherence for people living with HIV had net cost savings (compared to usual adherence communication) of up to US $15,726 per QALY (Quality Adjusted Life Years) 5.

 

References

  1. Vernon JA, Trujillo A, Rosenbaum SJ, DeBuono B. Low health literacy: Implications for national health policy. George Washington University: Department of Health Policy, School of Public Health and Health Services, 2007.
  2. Eichler K, Wieser S, Brügger U. The costs of limited health literacy: a systematic review. International journal of public health 2009; 54(5): 313-24.
  3. Schuster AL, Frick KD, Huh B-Y, Kim KB, Kim M, Han H-R. Economic Evaluation of a Community Health Worker-Led Health Literacy Intervention to Promote Cancer Screening Among Korean American Women. Journal of health care for the poor and underserved 2015; 26(2): 431-40.
  4. Herman A, Jackson P. Empowering low-income parents with skills to reduce excess pediatric emergency room and clinic visits through a tailored low literacy training intervention. Journal of health communication 2010; 15(8): 895-910.
  5. Ownby RL, Waldrop-Valverde D, Jacobs RJ, Acevedo A, Caballero J. Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence. BMC medical informatics and decision making 2013; 13(1): 29.

 

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