한국 노인의 미충족 돌봄과 살던 곳에서의 거주 의향의 관계: 건강 악화 시에 필요한 서비스 유형의 매개효과를 중심으로

초록

This study examined the association between unmet care needs and the intention to age in place among community-dwelling older adults with at least one limitation in activities of daily living (ADL) or instrumental activities of daily living (IADL), and assessed whether this relationship is mediated by perceived service needs. Using data from the 2023 National Survey of Older Koreans, the final analytic sample included 1,648 respondents. All analyses applied standardized survey weights and used logistic regression and Karlson–Holm–Breen (KHB) decomposition. Unmet care needs were positively associated with the intention to age in place under conditions of health deterioration (OR=1.977, 95% CI: 1.425–2.744). In the KHB decomposition, the total effect of unmet care needs was 0.689 (p<.001), and the total indirect effect explained through the perceived service needs pathway was 0.124 (p<.001), explaining 18.0% of the total effect. The perceived need for assistance with daily activities (care) showed the largest mediating contribution, accounting for 64.5% of the total indirect effect (indirect effect = 0.080). This mediation pathway was largely explained by the negative effect of unmet care needs on perceived service needs. These findings suggest that relying solely on AIP intention may underestimate latent care demand and underscore the need for proactive outreach to older adults with unmet care needs and efforts to improve awareness of available services.

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