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 =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.