Pain Prevalence and Pain Management at the End of Life: Regional and Urban-Rural Differences From a National-Representative Survey of Chinese Older Adults

Authors

Yaolin Pei
Xiang Qi
Zexi Zhou
Yifan Lou
Jing Wang
Yang Li
Bei Wu

Publication Date

2-5-2026

Journal

The Journals of Gerontology: Series A

DOI

10.1093/gerona/glaf282

PMID

41429569

PMCID

PMC12964578

PubMedCentral® Posted Date

3-7-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Effective pain management is essential for improving quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities.

Methods: We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who died during the study period. We conducted OLS regression analyses to examine the regional and rural-urban disparities in the associations between pain severity, place of death, and the quality of pain management.

Results: Severe pain at the end of life was reported for 42.6% of decedents. Severe pain and hospital death were associated with better quality of pain management. The association between hospital death and pain management quality was stronger in the Eastern region than in the Middle and Western regions. The associations between severe pain symptoms, place of death, and pain management quality were stronger in urban areas than in rural areas. The urban-rural disparities in pain management quality were stronger in the Eastern region than in the Middle and Western regions.

Conclusions: The regional and urban-rural disparities in end-of-life pain management in China highlight the urgent need to strengthen palliative care capacity in underresourced and rural areas through equitable expansion of home- and community-based services and integrated medical insurance reforms.

Keywords

pain management, place of death, urban-rural disparities, China, palliative care

Published Open-Access

yes

Recommended Citation

Pei, Yaolin; Qi, Xiang; Zhou, Zexi; et al., "Pain Prevalence and Pain Management at the End of Life: Regional and Urban-Rural Differences From a National-Representative Survey of Chinese Older Adults" (2026). Faculty, Staff and Student Publications. 6668.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6668