J Korean Med Sci. 2026 Jul 20;41(28):e65. doi: 10.3346/jkms.2026.41.e65.
ABSTRACT
BACKGROUND: Health literacy (HL) is increasingly recognized as a crucial determinant of healthcare utilization and costs. Despite its importance, empirical evidence on the relationship between HL and healthcare expenditures in South Korea is limited. This issue is particularly timely and relevant given the country’s rapidly rising outpatient expenditure.
METHODS: This study analyzed data from the Korea Health Panel Survey conducted in 2021 (n = 8,630) to examine the association between HL and outpatient healthcare costs. HL was measured using the Korean version of the Health Literacy Survey European Questionnaire 16 (range: 0-16) and categorized as high (≥ 13) or low (≤ 12). Outpatient expenditure was defined as the sum of insurance-covered payments, out-of-pocket spending, and non-covered services, excluding pharmaceutical costs. Expenditure data were log-transformed and analyzed using multivariable linear regression. Subgroup analyses by age group were conducted under the assumption that healthcare utilization patterns vary across age categories.
RESULTS: The results showed that individuals with high HL spent 8.6% less on outpatient care than those with low HL. Subgroup analyses further revealed that this association was statistically significant only among adults aged 65 years and older.
CONCLUSION: These findings provide evidence that higher HL is associated with reduced outpatient expenditures in South Korea, particularly in older populations. Therefore, promoting HL among older adults may represent an effective strategy for improving healthcare efficiency and mitigating the burden of rising outpatient costs.
PMID:42478249 | DOI:10.3346/jkms.2026.41.e65
