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Objectives: Our study aimed to explore patterns and predictors of hospital utilization among Chinese older adults in the context of a rapidly aging population and increasing health care costs in contemporary China. Methods: This study used a national representative sample aged 60 years or older (N = 11,511) from the China Longitudinal Aging Social Survey in 2014. We applied Andersen's social behavioral model and stepwise logistic regression to identify predictors of hospital utilization. Results: About 25% of the respondents were hospitalized in the previous year. Level of literacy, rural residence, social support, intergenerational relationships, and negative perceptions of aging were significant factors predicting hospital utilization. However, major variations existed across provinces in the use of hospitals. Discussion: Conclusions regarding how to integrate the complex range of hospital services more effectively and evenly are described. Social services should be developed in response to the hospital services utilization needs of older people. [ABSTRACT FROM AUTHOR]