Associating Multimorbidity Patterns With Healthcare Utilization and Unmet Healthcare Needs Among Older Koreans Living Alone

초록

Aim Despite multimorbidity being common among older adults living alone, its specific patterns and healthcare implications remain underexplored. This study aimed to identify distinct multimorbidity patterns among older Koreans living alone and to examine their associations with healthcare utilization and unmet healthcare needs.Methods Data were obtained from the 2023 National Survey of Older Adults, comprising 3423 community-dwelling Koreans aged >= 65 years living alone. Latent class analysis was employed to identify multimorbidity patterns based on 11 chronic condition groups. Multivariable regression was used to estimate associations between these patterns and three binary outcomes: outpatient service use, hospitalization, and unmet healthcare needs.Results Four distinct patterns emerged: "Low Comorbidity" (23.2%), "Hypertension Dominant" (58.3%), "Neurobehavioral Challenges" (6.7%), and "Mobility Challenges" (11.8%). Compared to the Low Comorbidity pattern, all other patterns were associated with significantly higher odds of outpatient service use, with the highest odds observed in the Mobility Challenges pattern (OR = 5.59). Notably, unmet healthcare needs were significantly higher in the Neurobehavioral Challenges (OR = 3.30) and Mobility Challenges (OR = 2.41) patterns. No significant associations were found for hospitalization.Conclusions Multimorbidity among older adults living alone is heterogeneous, with distinct patterns predicting varied healthcare outcomes. Specifically, individuals in the Neurobehavioral Challenges and Mobility Challenges patterns reported a co-occurrence of higher unmet needs alongside frequent clinical visits. These findings support a policy shift from traditional single-disease management toward person-centered, multimorbidity-informed integrated care to promote sustainable aging in place for this population.

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