The aim of this study is to understand the utilization of inpatient services and its contributing factors among middle-aged and elderly females (MAEF) in less developed rural regions. Five surveys were conducted between 2006 and 2014 with rural residents of Jiangxi by stratified cluster random sampling. Participant females included only those who were aged 45 and above. Complex sampling logistics analysis was performed to analyze the effect of three factors on inpatient service. Complex sampling logistics regression analysis revealed that the probability of hospitalization for the divorced or widowed females was significantly lower than that of married ones (aOR = 0.177, < 0.05). However, the probability of early discharge was significantly higher among divorced or widowed females than married ones (aOR = 3.237, < 0.05). In addition, females with chronic diseases were more likely to be hospitalized (aOR = 3.682, < 0.05). Also, early discharge (aOR = 7.689, < 0.05) occurred among the participants who should be hospitalized but were not hospitalized occurred (aOR = 3.258, < 0.05). The continuous improvement of the new rural cooperative medical policy has promoted the utilization of inpatient services for the MAEF. Findings from this study emphasize the need to strengthen the prevention and treatment of chronic diseases among middle-aged and elderly women.