Ageing, Disabilities, and Healthcare Utilisation: How Economic Growth Affects Public Service Inequity

Unmet healthcare needs remain a major barrier to achieving universal health coverage (UHC) globally. The intersection of aging and disability intensifies individual vulnerability and deepens structural health inequalities. Using Andersen’s Behavioural Model of healthcare utilisation as the theoretical framework, this study examines the determinants of healthcare utilisation at the individual and contextual levels among older adults with disabilities living in China. We use a dataset in China from 319 prefectures, with a total sample size of 634,445 individuals. Our findings reveal the presence of higher-income and urban-residence advantages in healthcare utilisation for older adults with disabilities in China. Regional economic development positively affects healthcare utilisation and reduces urban-rural inequality in healthcare utilisation, but its impact on income-based inequality is limited. These results highlight the need for targeted social assistance programmes for low-income groups to promote universal healthcare coverage and social equity.