Abstract: Objective To investigate the current status and analyze the influencing factors of inpatient service utilization among middle-aged and elderly individuals in China with hypertension, hyperglycemia, and dyslipidemia. Methods Based on data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), residents aged ≥45 years who were diagnosed with at least one of the following conditions—hypertension, hyperglycemia, or dyslipidemia—were selected for this study. Employing the Andersen Health Behavior Model, a binary logistic regression analysis was conducted to identify the determinants of inpatient service utilization within this "three-highs" population. Results Among the 8 227 middle-aged and elderly individuals with at least one of the "three-highs", 1 919 (23.33%) had utilized inpatient services in the preceding year. The logistic regression analysis revealed that several factors were significantly associated with inpatient service utilization (P<0.05). These included age (≥65 years OR=1.336), type of medical insurance (Urban and Rural Resident Basic Medical Insurance OR=0.757; Other/No Insurance OR=0.676), number of "three-highs" conditions (2 conditions: OR=1.287; 3 conditions: OR=1.892), limitations in Activities of Daily Living (ADL) (Yes OR=1.387), limitations in Instrumental Activities of Daily Living (IADL) (Yes OR=1.410), depressive symptoms (Present OR=1.248), presence of pain (Present OR=1.481), utilization of physical examination services (Utilized OR=1.225), duration of midday napping (60 to <120 min OR=1.230; ≥120 min OR=1.266), and alcohol consumption (OR=0.780). Conclusion The utilization rate of inpatient services among the middle-aged and elderly population with "three-highs" in China is relatively low. The primary influencing factors include age, type of medical insurance, number of comorbidities, ADL and IADL limitations, depressive symptoms, presence of pain, utilization of physical examinations, midday nap duration, and alcohol consumption. It is recommended that multifaceted interventions be implemented to effectively enhance the health management level of this population.

Key words: Hypertension, Hyperglycemia, Dyslipidemia, Inpatient services utilization, Influencing factors