Johan Franzén|Sarah Mantwill|R. Rapold|Peter Schulz
The relationship between functional health literacy and the use of the health system by diabetics in Switzerland
Helsana Group (Switzerland)|Università della Svizzera italiana|Helsana Group (Switzerland)|Università della Svizzera italiana
observational studies usa suggested patients low health literacy hl higher health care costs use inefficient mix health care services date studies europe investigated impact hl use health system purpose study measure functional hl among persons type 2 diabetes investigate relationship functional hl health care costs utilizationthe study population insured persons basic health insurance plan largest health insurer switzerland persons selected participation reimbursed diabetes medications 201011 aged 3570 years live longterm care institution level functional hl measured one screening question following dependent variables used total costs outpatient costs inpatient costs days admitted number physician visits attended multiple regression analyses adjusted age gender education duration diabetes treatment insulin yesno chronic disease yesnohigh levels functional hl associated lower total costs p 0007 lower outpatient costs p 0004 less physician visits p 0001 standard insurance plan free access health professionals subgroup effects found pronouncedpersons low functional hl need extra medical support therefore higher health care costs