University of Kansas|University of Kansas|National Development and Research Institutes|The University of Texas at Tyler|Children's Mercy Hospital
health literacy presents enormous challenge delivery effective healthcare quality outcomes evaluated impact low health literacy lhl healthcare utilization healthcare expendituredatabase analysis used medical expenditure panel survey meps 20052008 provides nationally representative estimates healthcare utilization expenditure health literacy scores hlss calculated based validated predictive model scored according national assessment adult literacy naal hls ranged 0500 health literacy level hll categorized 2 groups basic basic hls 226 basic hls 226 healthcare utilization expressed physician nonphysician emergency room er visits healthcare spending expenditures adjusted 2010 rates using consumer price index cpi p value 005 less criterion statistical significance analyses multivariate regression models assessed impact predicted hlls outpatient healthcare utilization expenditures analyses performed sas stata 110 statistical softwarethe study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally 20052008 cohort average age 49 years included females 57 caucasian predominant racial ethnic group 83 37 cohort south region united states america proportion cohort basic basic health literacy 224 annual predicted values physician visits nonphysician visits er visits 66 48 02 respectively basic basic compared 44 26 01 basic predicted values office er visits expenditures 1284 151 respectively basic basic 719 100 basic p 05 extrapolated national estimates show annual costs prescription alone adults lhl possibly associated basic basic health literacy could potentially reach 172 billionhealth literacy inversely associated healthcare utilization expenditure individuals basic basic hll greater healthcare utilization expendituresspending prescriptions compared individuals basic hll public health strategies promoting appropriate education among individuals lhl may help improve health outcomes reduce unnecessary healthcare visits costs