Analysis of access and utilization of health services among urban and rural communitie: A cross-sectional study

Background: Disparities in access and utilization of health services between urban and rural communities remain a major global public health concern. Geographic, socioeconomic, and structural differences often influence healthcare accessibility, preventive service uptake, and chronic disease management outcomes, particularly among aging populations. Understanding these disparities is essential for developing equitable health policies and improving health system performance. Objective: This study aimed to analyze differences in access and utilization of health services among urban and rural communities in China and identify factors associated with healthcare utilization patterns. Methods: This study used a quantitative cross-sectional design following the STROBE guideline for observational research reporting. A multistage stratified sampling approach recruited adults aged 45 years and above from urban and rural communities. Data were collected using structured questionnaires covering demographic characteristics, socioeconomic status, health status, healthcare access, and utilization behaviors. Descriptive statistics summarized respondent characteristics, while chi-square tests analyses examined associations between residence and healthcare utilization indicators. Results: The findings showed significant disparities between urban and rural populations in healthcare access and utilization. Urban residents reported higher outpatient visits, preventive health check-ups, and health education participation compared with rural residents. Rural communities experienced greater barriers related to distance to healthcare facilities, affordability of services, and lower health insurance coverage. Educational level, socioeconomic status, and perceived health condition influenced healthcare utilization patterns across geographic populations. Conclusion: The study concludes that urban–rural disparities in healthcare access and utilization persist due to structural, socioeconomic, and geographic determinants. Health policy should prioritize equitable healthcare infrastructure distribution, improved financial protection mechanisms, expanded health education programs, and community-based outreach strategies.