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The Journal of the American Board of Family Practice 17:44-47 (2004)
© 2004 American Board of Family Practice

Relationship Between Health Care Costs and Very Low Literacy Skills in a Medically Needy and Indigent Medicaid Population

Barry D. Weiss, MD and Raymond Palmer, PhD

From the Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson (BDW), and Department of Family and Community Medicine, University of Texas Health Science Center San Antonio, San Antonio (RP)

Correspondence: Address correspondence to Barry D. Weiss, MD, Department of Family and Community Medicine, University of Arizona College of Medicine, 1450 North Cherry, Tucson, AZ 85719 (e-mail: bdweiss{at}u.arizona.edu)

Objectives: Previous research established that low literacy is independently associated with poorer health. Our objective was to determine whether low literacy skill also is associated with higher health care charges.

Methods: We studied persons enrolled in Medicaid because of medical need/indigence by testing literacy skills in English or Spanish and measuring annual health care charges. Statistical analyses determined if, after adjusting for sociodemographic variables, literacy was associated with charges.

Results: Mean charges among subjects with very low literacy skills (<=3rd-grade reading level) were $10,688/year, but only $2,891 for those with better literacy skills (>=4th-grade reading level), statistically significant difference (P = .025). This difference persisted after adjustment for potentially confounding sociodemographic variables.

Conclusions: Based on this small study, very limited reading skills seem to be independently associated with higher health care charges among medically needy and medically indigent Medicaid patients.




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