From health literacy to emergency room: understanding the factors behind adult emergency visits

BACKGROUND: It is believed that low health literacy (HL) is associated with inappropriate use of emergency departments (ED). The volume of ED visits in Turkey continues to increase. This study aimed to evaluate the effects of adults' HL level, reasons for attending the ED, frequency of visits and trust in health news on social media on HL level and ED visits. METHODS: This prospective cross-sectional study was conducted at a university hospital ED in Istanbul from December 2021 to January 2023. Participants were adults (>18 years) admitted to the green or yellow triage areas, representing non-urgent or moderately urgent conditions. Data were collected through a Personal Information Form and the Turkish Health Literacy Scale-32 (THLS-32), administered either face to face or online. RESULTS: A total of 466 participants (mean age 30.3±12.9 years, 71.7% female) were included. Most participants were university graduates. The mean THLS-32 score was 30.35±10.11 (range 0-50), with only 13.9% (42-50 points) classified as having 'excellent' HL. Participants who reported relying on social media for health news and those who visited the ED due to 'long waits for a hospital outpatient clinic' had lower THLS-32 scores. There was no statistically significant association between HL and frequent ED attendance, age, gender or educational level. CONCLUSION: Lower HL is associated with greater reliance on unverified information in social media for health news and ED attendance due to long outpatient waits. Our findings highlight the need for targeted HL and digital HL initiatives to reduce avoidable ED visits and strengthen healthcare navigation skills.