ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1650570
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 99 articles
The impact of end-of-life disability level on middle-aged and older adults' utilization of medical services
Provisionally accepted
- 1School of Management, Xuzhou Medical University, Xuzhou, China
- 2Institution of Chinese Health Modernization, Xuzhou Medical University, Xuzhou, China
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Abstract Background: As healthcare demands often intensify during the final stages of life, this study examines the intricate associations between disability severity and patterns of medical service utilization in end-of-life care. Methods: The data originate from the 2020 China Health and Retirement Longitudinal Study database (CHARLS). The activities of daily living scale and the instrumental activities of daily living scale are utilized to assess levels of functional disability. This cross-sectional study employed Poisson regression and Tobit regression to assess the influence of disability on the frequency and expense of outpatient and inpatient services utilized during the terminal phase. Results: The average scores of the activities of daily life and instrument activities of daily life were 10.83 ± 5.71 and 11.55 ± 5.88. The disability level of respondents in the end-stage of life was an important factor affecting the frequency of outpatient and inpatient medical services and inpatient service expenses, where the regression coefficients were 0.028 (P<0.01), 0.014 (P<0.05), and 1091.4 (P<0.01), respectively. The partial marginal utility of the disability level for increasing inpatient expenses was 433.4 (P<0.01). Conclusion: Severe disability levels predict an economic burden on families of respondents at the end of lives. This underscores the urgent necessity for targeted disability-focused interventions to alleviate economic burdens and ensure familial well-being.
Keywords: End of Life, Activities of Daily Living, Medical services, Middle-aged and older adults, Poisson regression, Tobit regression
Received: 20 Jun 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Huang, Liu, Pan, Yan, Zhu, Miao and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yun Zhao, cyzhaoyun@126.com
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