Effective vascular access (VA) is an essential condition for providing hemodialysis, affecting patients' health outcomes. We aim to explore how health literacy (HL) as a non-clinical factor is associated with the decision-making process regarding VA type selection. Using data from 20 dialysis centers across Slovakia (n = 542, mean age = 63.6, males = 60.7%), the association of HL with type of VA (arteriovenous fistula (AVF) vs. central venous catheter (CVC)) was analyzed using a logistic regression model adjusted for sociodemographic characteristics and comorbidity. Sociodemographic data and data on nine domains of HL were collected by questionnaire. Data on VA and comorbidity were obtained from a medical records. Patients with a greater ability to engage with healthcare providers (odds ratio (OR): 1.34; 95% confidence interval (CI): 1.00-1.78), those with a better ability to navigate the healthcare system (OR: 1.41; 95% CI: 1.08-1.85), those more able to find good health information (OR: 1.52; 95% CI: 1.15-2.03), and those who understand it well enough to know what to do (OR: 1.52; 95% CI: 1.12-2.06) are more likely to have AVF. Patients' HL is associated with the type of VA; therefore, it should be considered in the decision-making process regarding the selection of the type of VA, thereby informing strategies for improving patients' HL and doctor-patient communication.

1 Surgery Clinic Faculty of Medicine P J Safarik University Trieda SNP 1 040 11 Kosice Slovakia

2 Internal Clinic Faculty of Medicine P J Safarik University Trieda SNP 1 040 11 Kosice Slovakia

Department of Health Psychology and Research Methodology Faculty of Medicine P J Safarik University Trieda SNP 1 040 11 Kosice Slovakia

FMC dialysis services Slovakia Trieda SNP 1 040 11 Kosice Slovakia

Graduate School Kosice Institute for Society and Health P J Safarik University Trieda SNP 1 040 11 Kosice Slovakia

Olomouc University Social Health Institute Palacky University in Olomouc Univerzitni 22 771 11 Olomouc Czech Republic

Vascular Surgery Clinic Faculty of Medicine P J Safarik University Trieda SNP 1 040 11 Kosice Slovakia

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