| Sumario: | The Chinese government launched the Home and Community‐Based Services (HCBSs) pilot program in 2016 to tackle the unmet care needs of the aging population. This study seeks to evaluate the association between HCBS usage and healthcare utilization and to examine whether this relationship is influenced by place of residence and gender. We used data from the 2015 and 2018 waves of the China Health and Retirement Longitudinal Study and applied propensity score matching with difference‐in‐differences (PSM‐DID) to investigate the link between HCBS usage and healthcare utilization. The final sample comprised 9280 older adults. Findings revealed a significant positive association between HCBS usage and the number of outpatient visits in the past month (β = 0.031, p < 0.05), outpatient out‐of‐pocket (OOP) expenditure (β = 0.223, p < 0.01), and total outpatient expenditure (β = 0.220, p < 0.01). However, HCBS usage showed no association with the number of hospitalizations in the past year, inpatient OOP expenditure, or total inpatient expenditure (all p > 0.05). Heterogeneity analysis indicated that the urban–rural background significantly moderated the association between HCBS and inpatient care, while these associations between HCBS and healthcare utilization did not vary by gender. Policymakers should prioritize integrating HCBS with healthcare services when designing and implementing healthcare and HCBS policies to optimize resource utilization and improve service efficiency. Moreover, additional efforts are warranted to ensure the equitable distribution of HCBS and healthcare resources between urban and rural areas.
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