Housing resources, perceived support needs and residential preferences across hypothetical health scenarios among older adults in Korea: a cross-sectional study

Background. Residential preferences may depend on anticipated functional circumstances and the support required to remain at home. We examined associations of housing resources and perceived support needs with current-home preference across two hypothetical health scenarios and with alternative residential destinations. Methods. This cross-sectional secondary analysis included 9951 self-responding community-dwelling adults aged 65 years or older from the 2023 National Survey of Older Koreans. Survey-weighted logistic and multinomial models incorporated clustering by 977 primary sampling units. Model-standardised probability contrasts and paired cross-scenario contrasts were estimated. Results. Weighted current-home preference was 87.2% under maintained health and 48.9% under declining health, a paired maintained-minus-declining difference of 38.3 percentage points (95% confidence interval [CI] 35.7 to 41.0). Adjusted owner-occupancy contrasts were 9.3 and 15.1 percentage points, respectively; the declining-minus-maintained difference was 5.8 points (95% CI 0.6 to 10.9). Daily-living support need was associated with contrasts of − 1.0 and − 15.8 percentage points, respectively; the declining-minus-maintained difference was − 14.8 points (95% CI − 19.2 to − 10.4). Under declining health, adjusted relative risk ratios comparing senior-housing with long-term-care-facility preference were 1.72 (95% CI 1.29 to 2.28) for housing-improvement need and 0.65 (95% CI 0.48 to 0.89) for daily-living support need. Conclusions. Housing resources and perceived support needs were associated with scenario-specific and destination-specific residential preferences. These findings may inform discussions of future living arrangements and support requirements in geriatric care.