AUTHOR=Huang Xiaojing , Liu Wenqin , Pan Qi , Yan Man , Zhu Lili , Miao Chunxia , Zhao Yun 

TITLE=The impact of end-of-life disability level on middle-aged and older adults’ utilization of medical services

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1650570

DOI=10.3389/fpubh.2025.1650570

ISSN=2296-2565

ABSTRACT=BackgroundAs 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.MethodsThe 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.ResultsThe 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).ConclusionSevere 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.