Exploring the role of unmet healthcare needs in the association between health literacy and health-related quality of life: a cross-sectional study using Korea national health and nutrition examination survey data

Health literacy and unmet healthcare needs have each been associated with health-related quality of life (HRQoL). However, few studies have examined these three factors simultaneously. Therefore, this study examined the associations among health literacy, unmet healthcare needs, and HRQoL in Korean adults. This cross-sectional study analyzed data from the 2024 Korea National Health and Nutrition Examination Survey (KNHANES) and included 5,351 adults aged 19 years or older. Health literacy was measured using the 10-item KNHANES health literacy questionnaire, unmet healthcare needs were assessed using a single self-reported survey item, and HRQoL was measured using the EuroQol-5 Dimension (EQ-5D) index. Complex sample logistic regression and general linear models were used for the analyses. Higher health literacy was significantly associated with better HRQoL (B = 0.002, p < .001) and a greater likelihood of reporting unmet healthcare needs (OR = 1.028, 95% CI = 1.008–1.049, p = .007). Unmet healthcare needs were significantly associated with lower HRQoL (B = − 0.037, p < .001). Health literacy and unmet healthcare needs were each independently associated with HRQoL among Korean adults. Strategies to improve HRQoL should therefore address both health literacy and unmet healthcare needs simultaneously.