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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 ( or =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.
Weiss et al. (Thu,) studied this question.