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Health Literacy

An Economic Perspective

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The costs of limited health literacy: a systematic review

Eichler, K., Wieser, S. & Brügger, U. Int J Public Health (2009) 54: 313. doi.org/10.1007/s00038-009-0058-2


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.