Journals / Uluborlu Mesleki Bilimler Dergisi / 2026 / Cilt: 9 Sayı: 2026

The Role of Health Literacy and Socio-Demographic Determinants in Healthcare Demand Postponement Behavior: A Cross-Sectional Study

Sağlık Hizmeti Talep Erteleme Davranışında Sağlık Okuryazarlığı ve Sosyo-Demografik Belirleyicilerin Rolü: Kesitsel Bir Araştırma

Hakan Oğuz Arı(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, GÜLHANE SAĞLIK BİLİMLERİ FAKÜLTESİ)0000-0001-5817-0916
Fatma Nur Şahin(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, GÜLHANE SAĞLIK BİLİMLERİ FAKÜLTESİ, SAĞLIK YÖNETİMİ BÖLÜMÜ, SAĞLIK YÖNETİMİ ANABİLİM DALI)0009-0006-3785-8686
Pages
1–17
Publication Date
2026-10-27
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The findings revealed a weak negative relationship of borderline statistical significance between health literacy and healthcare demand delay behavior (r=-0.092, p=0.050).

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Despite improvements in access to healthcare services, delaying healthcare seeking remains a significant public health concern.
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Key Findings & Data:This descriptive, cross-sectional study included 453 participants aged 18 years and older living in Türkiye, who completed an online survey.
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Conclusion & Impact:The findings revealed a weak negative relationship of borderline statistical significance between health literacy and healthcare demand delay behavior (r=-0.092, p=0.050).
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Sağlık Hizmeti Talebi · Sağlık Hizmetlerine Erişim · Sağlık Okuryazarlığı

Abstract

Despite improvements in access to healthcare services, delaying healthcare seeking remains a significant public health concern. This study aimed to examine the relationship between health literacy and healthcare-seeking delay among adults and to evaluate differences according to sociodemographic characteristics. This descriptive, cross-sectional study included 453 participants aged 18 years and older living in Türkiye, who completed an online survey. Data were analyzed using the independent samples t-test, one-way analysis of variance (ANOVA), Pearson correlation, and multiple linear regression analyses. The findings revealed a weak negative relationship of borderline statistical significance between health literacy and healthcare demand delay behavior (r=-0.092, p=0.050). Furthermore, multiple regression analysis demonstrated that the practical effect size of health literacy in explaining delay behavior remained extremely limited (Adjusted R²=0.006, accounting for 0.6% of the variance). In addition, younger adults, single individuals, those with lower income, without health insurance, experiencing difficulties in accessing healthcare services, and without chronic diseases exhibited higher levels of healthcare-seeking delay. The results indicate that healthcare-seeking delay is associated not only with health literacy but also with economic, structural, and healthcare access–related factors.

Özet

Günümüzde sağlık hizmetlerine erişim olanaklarının artmasına rağmen, sağlık hizmeti talep erteleme davranışı önemli bir halk sağlığı sorunudur. Bu araştırma, yetişkin bireylerde sağlık okuryazarlığı ile sağlık hizmeti talep erteleme davranışı arasındaki ilişkiyi ve sosyo-demografik farklılıkları incelemeyi amaçlamaktadır. Tanımlayıcı ve kesitsel nitelikteki araştırmanın verileri, Türkiye'de yaşayan 18 yaş ve üzeri 453 katılımcıdan çevrimiçi anket yoluyla toplanmıştır. Veriler, bağımsız örneklem t-testi, tek yönlü varyans analizi (ANOVA), Pearson korelasyon ve çoklu doğrusal regresyon analizleriyle değerlendirilmiştir. Bulgular, sağlık okuryazarlığı ile sağlık hizmeti talep erteleme davranışı arasında istatistiksel olarak tam sınır değerde ve zayıf negatif bir ilişki olduğunu göstermiştir (r=-0,092; p=0,050). Çoklu regresyon analizinde ise sağlık okuryazarlığının erteleme davranışını açıklamadaki pratik etki büyüklüğünün son derece sınırlı kaldığı (Düzeltilmiş R² = 0,006, varyansın %0,6'sı) saptanmıştır. Ayrıca genç, bekar, düşük gelirli, sağlık güvencesi olmayan, sağlık hizmetlerine erişimde güçlük yaşayan ve kronik hastalığı bulunmayan bireylerin erteleme davranışının daha yüksek olduğu belirlenmiştir. Sonuçlar, sağlık hizmeti talep ertelemesinin sağlık okuryazarlığının yanı sıra ekonomik, yapısal ve erişimle ilişkili faktörler çerçevesinde şekillendiğini göstermektedir.

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Cite This Article

Arı, H. O., Şahin, F. N. (2026). The Role of Health Literacy and Socio-Demographic Determinants in Healthcare Demand Postponement Behavior: A Cross-Sectional Study. Uluborlu Mesleki Bilimler Dergisi, Cilt: 9 Sayı: 2026, 1–17. https://doi.org/10.71445/umbd.2008344

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References (40)

  1. Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208–220.
  2. Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49(1), 15–24. https://doi.org/10.1037/0003- 066X.49.1.15
  3. Afşar, F., & Özkan, A. (2023). The health literacy and health-seeking behavior of patients with a chronic disease requiring hospitalization. Cam & Sakura Medical Journal, 3(1), 19–26. https://doi.org/10.4274/csmedj.galenos.2022.2022-11-13
  4. Akakpo, M. G., & Neuerer, M. (2024). The relationship between health literacy and health-seeking behavior amongst university students in Ghana: A cross-sectional study. Health Science Reports, 7(5), e2153. https://doi.org/10.1002/hsr2.2153
  5. Akyüz, S. (2021). Sağlık okuryazarlığı araştırmalarının bibliyometrik analizi. Genel Tıp Dergisi, 31(4), 402–416. https://doi.org/10.54005/geneltip.975248
  6. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10. https://doi.org/10.2307/2137284
  7. Baker, D. W. (2006). The meaning and the measure of health literacy. Journal of General Internal Medicine, 21(8), 878– 883. https://doi.org/10.1111/j.1525-1497.2006.00540.x
  8. Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97–107. https://doi.org/10.7326/0003- 4819-155-2-201107190-00005
  9. Çağatay, A. (2024). Hekime güvenin sağlık hizmeti talebi erteleme davranışı üzerine etkisi. Turkish Studies-Economics, Finance, Politics, 19(1), 143–157. http://dx.doi.org/10.7827/TurkishStudies.73785
  10. Duong, T. V., Aringazina, A., Kayupova, G., Nurjanah, Pham, T. V., Pham, K. M.,. Chang, P. W. (2019). Development and validation of a new short-form health literacy instrument (HLS-SF12) for the general public in six Asian countries. HLRP: Health Literacy Research and Practice, 3(2), e91–e102. https://doi.org/10.3928/24748307-20190225-01
  11. Erişen, M. A. (2024). Effect of health literacy and patient activation on health-seeking behaviour: A cross-sectional study in Turkey. Health Expectations, 27(5), e70052. https://doi.org/10.1111/hex.70052
  12. Fan, Z., Yang, Y., Yin, R., Tang, L., & Zhang, F. (2021). Effect of health literacy on decision delay in patients with acute myocardial infarction. Frontiers in Cardiovascular Medicine, 8, 754321. https://doi.org/10.3389/fcvm.2021.754321
  13. George, D., & Mallery, P. (2010). SPSS for Windows step by step: A simple guide and reference 17.0 update (10th ed.). Pearson
  14. Karahan Yılmaz, S., & Eskici, G. (2021). Sağlık Okuryazarlığı Ölçeği-Kısa Form ve Dijital Sağlıklı Diyet Okuryazarlığı Ölçeğinin Türkçe formunun geçerlik ve güvenirlik çalışması. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(3), 19–25.
  15. Kickbusch, I., & Brindley, C. (2013). Health in the post-2015 development agenda: An analysis of the UN-led thematic consultations, High-Level Panel report and sustainable development debate in the context of health. World Health Organization.
  16. Kline, R. B. (2015). Principles and practice of structural equation modeling (4th ed.). Guilford Publications
  17. Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America's adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006–483). National Center for Education Statistics.
  18. Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099–1104. https://doi.org/10.1016/S0140-6736(05)71146-6
  19. Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259–267. https://doi.org/10.1093/heapro/15.3.259
  20. Özen, M. Y. (2026). Predictors of healthcare demand procrastination among young adults: Perceived access and health literacy. Journal of Contemporary Medicine, 16(2), 102–108. https://doi.org/10.16899/jcm.1877781
  21. Özkan, S., Uğraş Dikmen, A., Baran Aksakal, F., Çalışkan, D., Tüzün, H., Taşçı, Ö.,. (2018). Türkiye sağlık okuryazarlığı düzeyi ve ilişkili faktörleri araştırması. Sağlık Bakanlığı.
  22. Paasche-Orlow, M. K., & Wolf, M. S. (2007). The causal pathways linking health literacy to health outcomes. American Journal of Health Behavior, 31(Suppl. 1), S19–S26.
  23. Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Rahman, M. H. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161–171. https://doi.org/10.1196/annals.1425.011
  24. Ratnapradipa, K. L., Jadhav, S., Kabayundo, J., Wang, H., & Smith, L. C. (2023). Factors associated with delaying medical care: Cross-sectional study of Nebraska adults. BMC Health Services Research, 23(1), 118. https://doi.org/10.1186/s12913-023-09140-0
  25. Sağlık Bakanlığı. (2024). Türkiye sağlık okuryazarlığı düzeyi ve ilişkili faktörleri araştırması. T.C. Sağlık Bakanlığı Sağlığın Geliştirilmesi Genel Müdürlüğü.
  26. Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23–74.
  27. Silkane, V., & Austers, I. (2018). Health procrastination: The experience of 35–44 years old men. SHS Web of Conferences, 51, 03002. https://doi.org/10.1051/shsconf/20184002007
  28. Sirois, F. M. (2023). Procrastination and stress: A conceptual review of why context matters. International Journal of Environmental Research and Public Health, 20(6), 5031. https://doi.org/10.3390/ijerph20065031
  29. Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., Kondilis, B., Stoffels, V., Osborne, R. H., & Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, 80. https://doi.org/10.1186/1471-2458-12-80 Arı & Şahin, Uluborlu Mesleki Bilimler Dergisi 9 (2026) 1-17 17
  30. Söyler, S. (2024). The effects of health beliefs on cancer screening and distrust in health systems on healthcare demand procrastination: A cross-sectional study. Online Turkish Journal of Health Sciences, 9(2), 143–149. https://doi.org/10.26453/otjhs.1413622
  31. Söyler, S., Uyar, S., Kıraç, R., Yılmaz, G., & Çiftçi Kıraç, F. (2022). Healthcare demand procrastination scale: Development and validation study. Journal of Basic and Clinical Health Sciences, 6(2), 617–626. https://doi.org/10.30621/jbachs.1068530
  32. Stead, R., Shanahan, M. J., & Neufeld, R. W. J. (2010). “I’ll go to therapy, eventually”: Procrastination, stress and mental health. Personality and Individual Differences, 49(3), 175–180. https://doi.org/10.1016/j.paid.2010.03.028
  33. Stormacq, C., Van den Broucke, S., & Wosinski, J. (2019). Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review. Health Promotion International, 34(5), e1–e17. https://doi.org/10.1093/heapro/day062
  34. Şantaş, G., Şantaş, F., & Kaya, S. (2023). Sağlık okuryazarlık düzeyi ile sağlık arama davranışı arasındaki ilişki: Bir alan araştırması. Hacettepe Sağlık İdaresi Dergisi, 26(3), 781–796.
  35. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Pearson. Uzun, S. U., & Akın, M. (2025). When tomorrow comes too late—The silent threat: Why people delay needed medical care in Türkiye. Journal of Public Health, 47(1), 45–53. https://doi.org/10.1093/pubmed/fdae309
  36. van Dijk, D. A., Meijer, R. M., van den Boogaard, T. M., Spijker, J., Ruhé, H. G., & Peeters, F. P. M. L. (2023). Worse off by waiting for treatment? The impact of waiting time on clinical course and treatment outcome for depression in routine care. Journal of Affective Disorders, 322, 205–211. https://doi.org/10.1016/j.jad.2022.11.011
  37. Waters, H. R. (2000). Measuring equity in access to health care. Social Science & Medicine, 51(4), 599–612. https://doi.org/10.1016/S0277-9536(00)00003-4
  38. Weissman, J. S., Stern, R., Fielding, S. L., & Epstein, A. M. (1991). Delayed access to health care: Risk factors, reasons, and consequences. Annals of Internal Medicine, 114(4), 325–331. https://doi.org/10.7326/0003-4819-114-4-325
  39. Duong, T. V., Aringazina, A., Kayupova, G., Nurjanah, Pham, T. V., Pham, K. M.,. Chang, P. W. (2019). Development and validation of a new short-form health literacy instrument (HLS-SF12) for the general public in six Asian countries. HLRP: Health Literacy Research and Practice, 3(2), e91–e102. https://doi.org/10.3928/24748307-20190225-01
  40. Özkan, S., Uğraş Dikmen, A., Baran Aksakal, F., Çalışkan, D., Tüzün, H., Taşçı, Ö.,. (2018). Türkiye sağlık okuryazarlığı düzeyi ve ilişkili faktörleri araştırması. Sağlık Bakanlığı.