Patterns and Associated Factors of Unmet Needs for Home- and Community-Based Health Services Among Older Adults in China: A Latent Class Analysis

Home- and community-based health services (HCBHS) play a crucial role in the management of chronic conditions and disabilities among older adults. This study identified patterns of unmet needs for HCBHS and determined the factors associated with these unmet needs using a nationally representative sample. Data derived from 9,358 older adults responding to the 2018 wave of the China Longitudinal Aging Social Survey. HCBHS included home nursing, in-home doctor visits, rehabilitation, assistive medical devices, and health lectures. Latent class analysis was used to identify patterns of unmet needs for HCBHS, and multinomial logistic models were used to determine the associated factors. Three unmet needs patterns were identified: no needs/met needs (68.4%), unmet needs (11.1%), and uncertain needs (20.5%). Experiencing pain, depression, self-rated health, higher health workforce density, and region were significantly associated with both unmet and uncertain needs. Furthermore, education, living in urban areas, type of social pension, instrumental activities of daily living, and heart disease were found to be associated with unmet needs, while age, marital status, and household income were associated with uncertain needs. The findings underscore the need to address unmet and uncertain needs, develop targeted interventions, and implement policies to support aging in place.