Does Workforce Participation After Retirement Age Affect the Use of Healthcare Services?

Background: Population ageing and the gradual implementation of delayed retirement policies have drawn increasing attention to the lives of older adults after retirement age. Although previous studies have examined the relationship between retirement and health outcomes, limited evidence is available on whether continued workforce participation after retirement age affects healthcare utilization. Methods: Using nationally representative data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we employ negative binomial regression as the baseline model and use an instrumental variable two-stage least squares (IV-2SLS) to address endogeneity. We further conduct heterogeneity and mechanism analyses. Results: The findings reveal that workforce participation after retirement age significantly reduces healthcare utilization: post-retirement workers have 42.1% fewer outpatient visits and 49.2% fewer inpatient admissions than their fully retired counterparts. Mechanism analyses indicate that the negative effect operates primarily through tighter time constraints that crowd out care-seeking time and income fluctuations that alter health investment behaviors. Heterogeneity analyses further show that the reduction in outpatient utilization is more pronounced among males and highly educated individuals, whereas the reduction in inpatient utilization is stronger for females and those with good self-rated health. Conclusions: Workforce participation after retirement age may hinder healthcare utilization among older adults. These findings reveal an unintended consequence of delayed retirement policies and call for flexible, targeted arrangements to balance labor participation and healthcare access for older workers.