The impact of e-health literacy on perceived access to healthcare services: a cross-sectional study among health sciences students in Istanbul, Turkey

E-health literacy has become an important skill for navigating modern, increasingly digital health systems. Evidence linking e-health literacy to perceived healthcare access among health sciences students, who represent the future healthcare workforce, remains limited in the Turkish context. This study examined the association between e-health literacy and perceived access to healthcare services among health sciences students in Istanbul. A cross-sectional study was conducted with 500 health sciences students from six universities in Istanbul, Turkey (ethics approval: Meeting No: 2026/02; Decision Date: 06 February 2026). The eHealth Literacy Scale (eHEALS) and a 23-item Perceived Access to Healthcare Services Scale (dimensions: Accessibility, Acceptability, Accommodation, Affordability) were administered via structured questionnaire. Confirmatory Factor Analysis (CFA) and second-order Structural Equation Modeling (SEM) were performed in LISREL 9.3, with discriminant validity evaluated using the Fornell–Larcker criterion and Heterotrait–Monotrait (HTMT) ratios and common method bias screened with Harman’s single-factor test. The structural model demonstrated good fit (χ²/df = 1.97; RMSEA = 0.051; CFI = 0.96; TLI = 0.95; SRMR = 0.047). E-health literacy was significantly and positively associated with perceived healthcare access (β = 0.62, p < 0.001, R² = 0.38). Among the four dimensions, Acceptability (λ = 0.92) and Accommodation (λ = 0.90) loaded most strongly on the higher-order access construct. Discriminant validity was supported for most construct pairs under both the Fornell–Larcker criterion and HTMT ratios, with one exception: Acceptability and Accommodation showed a Fornell–Larcker violation and an HTMT ratio of 0.916, exceeding the conservative 0.85 threshold and indicating limited discriminant validity between these two closely related dimensions. Higher e-health literacy was associated with more favorable perceptions of healthcare access among health sciences students in this sample. Given the cross-sectional design, these findings should be read as an association rather than evidence of a causal pathway. Structured digital health competency training in health sciences curricula may be a useful direction to explore further, ideally through longitudinal and cross-cultural replication.