title: Relationship between health care costs and very low literacy skills in a medically needy and indigent Medicaid population.
abstract: OBJECTIVE
  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 =3rd-grade reading level) were 10,688 dollars/year, but only 2,891 dollars for those with better 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.
authors.affiliation: Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ 85719, USA. bdweiss@u.arizona.edu
authors.forename: Barry D
authors.initials: BD
authors.lastname: Weiss
authors.forename: Raymond
authors.initials: R
authors.lastname: Palmer
mesh_terms: D000328:Adult; D000368:Aged; D001130:Arizona; D004522:Educational Status; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data*