Care inequality: care received according to gender, marital status, and socioeconomic status among Korean older adults with disability

BACKGROUND: We sought to identify the types of care and care resources available to older Korean adults with disabilities, and document the inequality in care received according to gender, marital status, and socioeconomic status. METHOD: Data were derived from the sixth wave of the Korean Longitudinal Study of Ageing. The sample consisted of 946 men and women who were disabled in ADL and IADL. Generalized linear models and analyses of covariance were used to evaluate group differences in types of care received and care resources. The outcome variables were main primary caregivers, the total number of available caregivers, hours of care received per day, number of days of care, and fees paid to caregivers. RESULTS: In total, 41.7% of men with ADL/IADL disabilities reported that they did not receive formal or informal care from any source, compared with 30.7% of women. Almost half (49.2%) of men without a spouse were in a state of care deficit (vs. 30.8% in women without a spouse, P < 0.001). Among care recipients, men reported receiving higher average days of care per month than women (25.6 vs. 21.2 days, P < 0.01). Both men and women received care primarily from their spouse, but adult children were more frequently care providers for older women than men. A combination of care from spouse and paid caregiver was more frequent among women. Dependent older people with high household incomes had a higher likelihood of receiving care There was the clear gradient in rate of paid formal caregivers use by household income (higher income = higher use) among women but not men. CONCLUSIONS: Care types and resources among disabled older adults appeared to be different by gender, marital status and socioeconomic status under the cultural phenomenon and contextual circumstances in the aging Korean population.