Objective  To explore current situation and influencing factors of health literacy of outpatients in China for providing evidences to improve health literacy in the population.

  Methods  With random cluster sampling, totally 2 808 outpatient clinic attendees aged 15 years and above were recruited at 14 secondary and tertiary hospitals in 8 provinces across China and a network-based onsite survey was conducted among the outpatients during January – May 2021 using a modified Chinese Patient Health Literacy Scale developed by domestic researchers previously.

  Results  Valid information were collected from all the participants. The average total score of the participants was 43.38 ± 6.25 for the health literacy scale scoring from 0 to 60 and the participants′ average dimension scores were 10.24 ± 3.17 for the concept of medical science, 9.20 ± 2.12 for disease self-management skills, 7.55 ± 1.54 for self-efficacy, 9.03 ± 2.10 for general medical knowledge, and 7.36 ± 2.21 for cognition in medical information, respectively. Of all the participants, 68.38% (1 920) were assessed as with health literacy based on their total score of 41 and above. Multivariate binary logistic regression analysis showed that the participants with following characteristics were more likely to have a higher health literacy: aged ≥ 35 years, with the education of senior/vocational high school or technical secondary school and above, having a mean household monthly income of ≥ 8 000 RMB yuan, averagely spending one hour and more per day on surfing the internet, acquiring medical information generally from medical staff, and with a good or very good self-perceived doctor-patient communication; while, the participants engaging in professional techniques and other works were more likely to have a lower health literacy.

  Conclusion  In Chinese outpatients, the health literacy is at relatively higher level and the literacy is influenced mainly by age, education, occupation, average monthly household income, mean daily time of internet use, doctor-patient communication, and the route of acquiring general medical information.