| Summary: | 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 (<i>n</i> = 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.
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