Influence of health literacy on primary healthcare utilization

Purpose: This study aims to evaluate the health literacy levels of individuals presenting to the emergency department with non-life-threatening and ambulatory care-appropriate conditions, and to investigate the relationship between health literacy defined as the ability to access, understand, and apply health information and primary care utilization. Materials and Methods: A cross-sectional analytical study was conducted between May and October 2023 at the green triage section of İzmir Atatürk Training and Research Hospital emergency department. A total of 326 participants were included. Health literacy was assessed using validated Turkish versions of REALM and NVS instruments. Sociodemographic data and healthcare utilization habits were collected via face-to-face interviews. Results: A total of 81.5% of particpants did not consult a family physician prior to their ED visit. According to REALM, 71.2% of participants had adequate health literacy, while this rate was 44.9% according to NVS. Chronic illness was reported by 43.7%, and 36.9% were on regular medication. Frequent family physician utilization was higher among women (57.8%), those with higher education (34.6% with university or higher), health insurance coverage (77.9%), chronic disease (43.7%), and regular medication use (36.9%). Health insurance increased the likelihood of family physician visits by 2.9 times, and regular medication use increased it by 3 times. Conclusion: Many emergency department visits could be managed at the primary care level. Enhancing health literacy particularly functional literacy, which involves individuals' ability to understand, interpret, and effectively apply health information in real-life situations and improving access to and the perception of family medicine services may help reduce potentially avoidable emergency department visits and contribute to more efficient health service delivery.