The costs of limited health literacy : a systematic review

Objectives: To summarize evidence about the costs of limited health literacy (HL) and 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 diabetes mellitus or 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