Classifying and Characterising Unmet Integrated Care Needs of Older Adults With Multimorbidity: A Latent Profile Analysis

J Clin Nurs. 2025 Jan 9. doi: 10.1111/jocn.17520. Online ahead of print.

Abstract

Aims: To classify the unmet integrated care needs of older adults with multimorbidity and to explore the factors associated with different categories of unmet integrated care needs among the target population.

Design: A cross-sectional survey using the statistical method of latent profile analysis.

Methods: From July 2022 to March 2023, 397 older adults with multimorbidity, aged 60 years or older, were recruited from one primary healthcare setting and from four secondary and tertiary hospitals to participate in face-to-face questionnaire surveys. The questionnaire used in this study to assess unmet integrated care needs among older adults with multimorbidity was self-designed through a series of steps, including a scoping review, expert consultation and cognitive interviews. Latent profile analysis was applied to uncover distinct profiles of unmet integrated care needs, and multinomial logistic regression was employed to explore whether the profiles were further distinguished by participants' sociodemographic and health-related covariates. The data were analysed using IBM SPSS v.29.0 and Mplus v.8.0.

Results: The optimal solution was a four-profile model, characterised by high unmet integration needs, high unmet system integration needs, low unmet system integration needs and low unmet integration needs, respectively. Multinomial logistic regression results indicated that profile differences were associated with place of residence, number of coresidents and the presence or absence of complex multimorbidity.

Conclusion: The integrated care needs of older adults with multimorbidity have not yet been fully met. Classifying and characterising unmet integrated care needs profiles is a crucial step in the rational allocation of integrated care resources.

Reporting method: This study was reported based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cross-sectional studies.

Patient or public contribution: All participants were older adults with multimorbidity, and they were informed that they could withdraw from the study at any time.

Keywords: care continuity; care coordination; healthcare needs assessment; healthcare service delivery; multiple chronic conditions.