ArticleBMJ open2026
Association between difficulties navigating the French healthcare system and healthcare utilisation: results from the National Health Literacy Survey (HLS
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine the association between navigational health literacy (HL), defined as the skills required to effectively navigate healthcare systems, access services and make informed decisions and healthcare utilisation among French adults with and without chronic health conditions.
designCross-sectional online survey.
settingNational survey conducted in metropolitan France as part of the Health Literacy Survey (HLS
participantsA total of 2 003 individuals were included: 1103 without chronic condition and 900 with at least one chronic condition. OUTCOMES MEASURES: Number of general practitioner (GP) and specialist visits in the previous 12 months
resultsThe chronic condition group reported more frequent GP (4.3 vs 2.1/year) and specialist (2.8 vs 1.1/year) visits than the no chronic condition group. A high navigational HL was significantly associated with fewer GP (p=0.016) and specialist visits (p<0.001) only in the latter group. Other significant variables were age, gender, financial difficulties, self-reported health status and activity limitations. Younger persons and men reported fewer visits while those with poorer health and activity limitations reported more visits.
conclusionsHigh navigational HL was associated with less healthcare utilisation in individuals with no chronic condition. Among the chronic condition group, this aspect seemed less influential, likely due to greater healthcare system familiarity and structured care. Our findings highlight the importance of strengthening HL navigation skills early to improve healthcare use.
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