Utilization of rehabilitation services among older persons with physical disabilities: an analysis of its association with socioeconomic status stratified by gender and age in China

Rehabilitation is a critical method for preventing and controlling disabilities. However, the majority of the global demand for rehabilitation services remains unmet, particularly in low- and middle-income countries. This study aims to explore the complex and concealed stratified relationships between socioeconomic status and the utilization of rehabilitation services among older persons with physical disabilities (PD) from gender and age perspectives. A total of 19,782 observations of older persons with PD were included from the 2007–2013 China National Disabled Persons Condition Monitoring data. This study employs a multiplicative interaction effect model based on logistic regression to analyze the differential association between individual socioeconomic status and the utilization of rehabilitation services, considering gender and age. From a gender perspective, the positive correlations between high income, high education and the utilization of rehabilitation services are smaller in males (high income: OR = 0.801, 95% CI 0.653–0.983; high education: OR = 0.679, 95% CI 0.433–1.066). From an age perspective, the positive correlation between high income and the utilization of rehabilitation services is greater among middle- to oldest-old individuals with PD (OR = 1.310, 95% CI 1.077–1.593). There are structural gender and age differences in the relationship between the socioeconomic status of older persons with PD and their utilization of rehabilitation services. It is recommended to enhance financial subsidies for rehabilitation services and implement tiered payment structures for low-income groups to alleviate their financial burden. To mitigate gender disparities in healthcare, efforts should focus on increasing awareness of rehabilitation services within health education programs, with community health workers playing a more active role in identifying and assisting those in need. Furthermore, strengthening support for family caregiving and integrating medical and nursing services within the framework of long-term care insurance are essential. Additionally, efforts should be made to the development of preventive rehabilitation programs and the establishment of a multi-tiered integrated rehabilitation system that ensures access to basic services for low-income populations and provides premium options to accommodate diverse needs.