Skip to main content
Top
Published in: Journal of Public Health 4/2024

10-02-2023 | Public Health | Original Article

The association between health literacy and medical out-of-pocket expenses among residents in China

Authors: Li Li, Yinghua Li, Xueqiong Nie, Lanlan Wang, Gang Zhang

Published in: Journal of Public Health | Issue 4/2024

Login to get access

Abstract

Aim

To explore the association between health literacy and medical out-of-pocket (MOOP) expenses among Chinese residents based on the 2020 China Health Literacy Survey.

Subjects and methods

Non-institutionalized residents aged 15–69 years were extracted from 31 provinces in China. Health literacy was assessed using the Chinese Health Literacy Scale.

Results

A total of 49,967 respondents were included in this study. Compared to participants with adequate health literacy, participants with intermediate, basic, and below basic health literacy were likely to create more MOOP, the unadjusted coefficients being 224.294 (p < 0.05), 316.676 (p < 0.01), and 458.883 (p < 0.01) respectively. After adjusting for demographic characteristics and socio-economic elements, health literacy was significantly associated with MOOP (β = −4.970, SE = 2.470, p < 0.05). Of six dimensions of health literacy, five were associated with MOOP in unadjusted models (p < 0.001 or p < 0.01). However, in adjusted models, only infectious disease literacy (β = −52.347, SE = 17.853, p < 0.01) and medical care literacy (β = −29.603, SE = 10.620, p < 0.01) remained associated with MOOP.

Conclusion

This study suggests that health literacy is significantly associated with medical expenditure. The adoption of disease prevention measures and the utilization of public health services are important elements. Improving health literacy should be give more importance in health promotion and public education for the general public.
Literature
go back to reference American Medical Association (1999) Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA 281:552–557 American Medical Association (1999) Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA 281:552–557
go back to reference Feigin V, GBD Causes of Death Collaborators (2018) Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392:1736–1788CrossRef Feigin V, GBD Causes of Death Collaborators (2018) Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392:1736–1788CrossRef
go back to reference Karimi S, Keyvanara M, Hosseini M et al. (2014) The relationship between health literacy with health status and healthcare utilization in 18-64 years old people in Isfahan. J Educ Health Prom 3 Karimi S, Keyvanara M, Hosseini M et al. (2014) The relationship between health literacy with health status and healthcare utilization in 18-64 years old people in Isfahan. J Educ Health Prom 3
go back to reference Kickbusch I, Pelikan J, Apfel F (2013) Health literacy: the solid facts. WHO Regional Office for Europe Kickbusch I, Pelikan J, Apfel F (2013) Health literacy: the solid facts. WHO Regional Office for Europe
go back to reference Li L, Li Y, Nie X (2015a) Analysis of factors affecting health literacy of Chinese residents in 2012. Chin J Health Educ 2015:104–107 Li L, Li Y, Nie X (2015a) Analysis of factors affecting health literacy of Chinese residents in 2012. Chin J Health Educ 2015:104–107
go back to reference Li Y (2014) Introduction of 2012 Chinese residents health literacy monitoring program. Chin J Health Educ 30:563–565 Li Y (2014) Introduction of 2012 Chinese residents health literacy monitoring program. Chin J Health Educ 30:563–565
go back to reference Li Y, Mao Q, Shi Q (2015b, 2015) 2012 Chinese residents’ health literacy monitoring results. Chin J Health Educ:99–103 Li Y, Mao Q, Shi Q (2015b, 2015) 2012 Chinese residents’ health literacy monitoring results. Chin J Health Educ:99–103
go back to reference Li YH, Nie XQ (2014) Contrast analysis of 2008 and 2012 national health literacy survey plan. Chin J Health Educ 2:176–177 Li YH, Nie XQ (2014) Contrast analysis of 2008 and 2012 national health literacy survey plan. Chin J Health Educ 2:176–177
go back to reference Institute of Medicine (US) Committee on Health Literacy (2004) Health Literacy: a prescription to end confusion. National Academies Press (US), Washington (DC) Institute of Medicine (US) Committee on Health Literacy (2004) Health Literacy: a prescription to end confusion. National Academies Press (US), Washington (DC)
go back to reference Liu L (2016) The research on the relation between health literacy and quality of life, direct medical cost of middle-aged of elderly hospitalized patients with coronary heart disease. Xinjiang Medical University Liu L (2016) The research on the relation between health literacy and quality of life, direct medical cost of middle-aged of elderly hospitalized patients with coronary heart disease. Xinjiang Medical University
go back to reference Nie XQ, Li YH, Li L (2014) Statistical analysis method of Chinese residents’ health literacy monitoring data in 2012. Chin J Health Educ 2:178–181 Nie XQ, Li YH, Li L (2014) Statistical analysis method of Chinese residents’ health literacy monitoring data in 2012. Chin J Health Educ 2:178–181
go back to reference Nutbeam D (1996) Health outcomes and health promotion-defining success in health promotion. Health Promot J Australia 6:58–60 Nutbeam D (1996) Health outcomes and health promotion-defining success in health promotion. Health Promot J Australia 6:58–60
go back to reference Quan W, Tao L, Chai P-p (2021) Study on monitoring and evaluation of the share of out-of-pocket payment in total health expenditure in China and its prediction. Chin Health Econ 40:33–36 Quan W, Tao L, Chai P-p (2021) Study on monitoring and evaluation of the share of out-of-pocket payment in total health expenditure in China and its prediction. Chin Health Econ 40:33–36
go back to reference Zhang K (2019) A study on the correlation between health literacy and quality of life, direct medical cost of type 2 diabetes mellitus in community. Henan University Zhang K (2019) A study on the correlation between health literacy and quality of life, direct medical cost of type 2 diabetes mellitus in community. Henan University
Metadata
Title
The association between health literacy and medical out-of-pocket expenses among residents in China
Authors
Li Li
Yinghua Li
Xueqiong Nie
Lanlan Wang
Gang Zhang
Publication date
10-02-2023
Publisher
Springer Berlin Heidelberg
Keyword
Public Health
Published in
Journal of Public Health / Issue 4/2024
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-022-01792-2

Other articles of this Issue 4/2024

Journal of Public Health 4/2024 Go to the issue