Digital health literacy and patient loyalty in smart hospitals: Insights from a qualitative Meta-Synthesis

The rapid digital transformation of healthcare has led to the emergence of smart hospitals that leverage technologies such as electronic health records, telemedicine, mobile health applications, and the Internet of Things.While these innovations hold promise for improving patient care and operational efficiency, the effectiveness of digital health interventions depends largely on patients' digital health literacy.This study presents a qualitative meta-synthesis of peer-reviewed research published between 2010 and 2025, examining how digital health literacy influences patient loyalty in smart hospital contexts.Using meta-ethnography and thematic synthesis approaches, 7 qualitative studies were analysed to identify overarching themes, including patient empowerment, trust in digital health systems, engagement with digital services, and organizational support for digital inclusion.Findings indicate that higher levels of digital health literacy enhance patient engagement, satisfaction, and long-term loyalty, while barriers such as digital inequality and limited organizational support may reduce these effects.The study offers a conceptual framework linking digital health literacy to patient loyalty and provides practical recommendations for hospital administrators to design patient-centred digital initiatives.These insights contribute to the theoretical understanding of patient engagement in digital healthcare and inform strategies for fostering loyalty in smart hospitals.