Abstract
BACKGROUND: Amid growing concerns over healthcare workforce shortages in aging societies, delayed retirement has emerged as a strategic policy response. However, little is known about the determinants of retirement attitudes across different healthcare professions in middle-income countries. OBJECTIVES: Guided by Role Theory and the Push-Pull Model, this study aimed to identify demographic, occupational, and psychosocial predictors of support for delayed retirement among healthcare workers in China, with attention to inter-professional variation. METHODS: A cross-sectional survey was conducted among 1,200 full-time healthcare workers in Sichuan Province, including doctors, nurses, technicians, and administrative staff. A structured questionnaire captured data on demographics, work conditions, job satisfaction, occupational fatigue, self-rated health, and chronic illness. Univariate and multivariate logistic regression analyses were used to identify independent predictors of support for delayed retirement. RESULTS: Support for delayed retirement was positively associated with older age (OR: 1.06), male gender (OR: 1.34), higher education (OR: 1.42–1.65), longer working hours, more frequent night shifts, and higher job satisfaction (OR: 1.55), while greater occupational fatigue was negatively associated (OR: 0.82; all p < 0.01). Supporters reported better health, lower fatigue, and greater career engagement. Subgroup comparisons revealed marked differences in predictors and attitudes across professional roles, reflecting distinct role identities and workplace demands. CONCLUSIONS: By applying retirement theory to a diverse healthcare sample, this study highlights the need for differentiated workforce retention strategies. Findings suggest that policies should account for occupational fatigue, gendered caregiving burdens, and role-based professional motivations to ensure sustainable retirement planning in resource-constrained health systems. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-24449-7.