Health literacy among patients attending primary and tertiary healthcare institutions: A comparison through family medicine and examination of associated factors

AIM: Health literacy is the ability of individuals to understand and evaluate health information and use this information to make healthy lifestyle decisions. Many factors influence health literacy. Our goal is to compare the health literacy levels of patients presenting to primary and tertiary healthcare institutions and to demonstrate the impact of this level on healthcare preferences. MATERIALS AND METHODS: This is a cross-sectional, descriptive study conducted with 500 individuals aged 18 and over who presented to the family medicine outpatient clinic or training family health center at Sakarya Education and Research Hospital. Data were collected through face-to-face interviews between October 1, 2024, and March 31, 2025. The first part of the survey included a 17-question demographic questionnaire, and the second part included the TSOY-32 scale, consisting of 32 questions. Analyses were conducted using IBM SPSS Statistics v. 26.0 for Windows (Armonk, NY: IBM), and the significance level was set at p<0.05. RESULTS: A significant difference was found among all participants with higher education and income levels, single, without children, with fewer applications to health institutions, without chronic diseases, with a good subjective health perception, and only among the Family Health Center group participants living in the city center; TSOY-32 scores were higher. CONCLUSION: Our study demonstrates the need for multidimensional and targeted interventions to improve health literacy. Priority target groups should include the elderly, those with low education and income, and those with chronic illnesses. Community-based education programs tailored to local cultures should be expanded. Economic support mechanisms should be established, and materials should be made available free of charge. Healthcare professionals' counseling skills should be strengthened to empower individuals to use the healthcare system more consciously. Keywords: Family medicine, health, health services, literacy