Balancing Health Literacy and Healthcare Expenditures: Evidence from a Social Security Fund

Background and Objectives: Health literacy is a crucial determinant of health outcomes and healthcare expenditures. Although health literacy is generally viewed as beneficial, its impact on healthcare expenditures, remains complex. This study aimed to ۱) assess the status of health literacy and healthcare expenditures among members of a social security fund, ۲) examine differences across various sociodemographic groups, and ۳) explore the effect of health literacy on healthcare expenditures.Materials and Methods: Data were collected from members of a social security fund through a health literacy questionnaire in ۲۰۲۲. Participants provided their insurance identification numbers, which were used to retrieve actual healthcare expenditure data from the social security fund's administrative database. This allowed for the linkage of self-reported health literacy data with corresponding expenditure records. Statistical analyses were conducted using parametric and non-parametric correlation tests, ANOVA, Kruskal-Wallis and quantile regression analysis.Results: The mean and median of health expenditure in the sample was ۷۰۳ thousand Rials  and ۲۵۷.۴ million IRR (equal to ۱۴۳.۳ and ۵۲۵.۳ US, respectively), with the highest expenditures among individuals with limited disability and those self-assessing their health as poor. Health literacy scores averaged ۷۱.۷ (SD±۱۵.۱), with higher scores among women, singles, and those with higher education. A quantile regression revealed that self-rated health consistently predicted lower costs, while health literacy was linked to higher spending at median and upper quantiles. Unemployment and student status were associated with significantly reduced costs, especially among higher spenders.Conclusion: This study underscores the complex relationship between health literacy and healthcare spending. Enhancing health literacy, while beneficial, should be accompanied by strategies to mitigate cost increases, particularly for vulnerable groups such as individuals with mild disabilities. Promoting realistic health perceptions and tailored interventions can optimize healthcare utilization, reduce unnecessary expenses, and ensure the effective allocation of resources within social security systems.

کلیدواژه ها:

Disability ، Healthcare expenditure ، Health Literacy ، Socioeconomic factors ، Self-Perceived Health ، Iran