Economic Cost of Health Illiteracy for Blacktown Hospital Blacktown-Mt Druitt Health Medical Staff Council: Final Report

Health literacy (HL) is defined as the skills, knowledge, motivation, and capacity of a person to access, understand, appraise and apply information to make effective decisions about health and health care and take appropriate action (Australian Commission on Safety and Quality in Health Care, 2014) (3). Patients with a greater level of HL report better clinical and hospital outcomes (19, 20). On the contrary, a low level of HL, in other words, 'health illiteracy' is not only associated with significant health burdens at the individual and community levels but also has economic ramifications at the practice and health-care system levels (23-26). At the health-care system level, a low HL is associated with increased economic burden. Evidence from the United States (US) suggests that the cost of low HL to the US economy was between $106 billion to $238 billion annually, which is almost 7 to 17% of all personal care expenditures. At the individual level, the cost of low HL ranged from $143 to $7798 per person per year, compared to individuals with adequate health literacy (40). Findings from the Health Literacy Questionnaire (HLQ) indicated that only one in four Australians strongly agreed to have sufficient information to manage their health. In terms of self-management of conditions, only 18% of Australians strongly agreed to actively managing their health (43). However, compared to those without a chronic illness, only 12% of Australians with multiple chronic conditions reported adequate levels of self-management behaviours and only 17% reported to actively engaging with a health care team (43). Findings of the study may provide policymakers with a deeper understanding of the economic burden of low HL in terms of health care and the production economy. It may also help determine who bears the burden of low HL, which may aid in efficient allocation of resources to alleviate the cost of low HL at individual and public health care provider, and government levels. With respect to future research, there is an opportunity to delve into all nine domains of the Health Literacy Questionnaire in order to obtain a deeper understanding and to evaluate the cost associated with the different aspects of HL. Once the data on PHN levels are available, future research could focus on comparing Western Sydney PHN population with that of the neighbouring PHNs (South Western and Nepean Blue Mountains PHNs) as well as with high performing and affluent PHNs (North Sydney PHN).