Unmet Healthcare Needs and Associated Factors Among Older Adults with Osteoporosis: A Cross-Sectional Analysis of the 2025 Korea Community Health Survey

Background: Unmet healthcare needs are a significant public health concern among older adults, particularly those with chronic conditions such as osteoporosis. This study aimed to identify several key factors associated with unmet healthcare needs among older adults with osteoporosis using Andersen’s behavioral model. Methods: This observational, cross-sectional study examined data from the 2025 Korea Community Health Survey, analyzing responses from 20,988 individuals aged ≥ 65 years with physician-diagnosed osteoporosis. General characteristics were analyzed using descriptive statistics in terms of frequencies and percentages. Variables were categorized into predisposing, enabling, and need factors. Complex sample analyses were performed using the Rao–Scott chi-square test and multivariable logistic regression. Results: In the multivariable analysis, female sex (adjusted odds ratio [aOR] = 1.44, 95% confidence interval [CI]: 1.08–1.91), poor health literacy (aOR = 1.56, 95% CI: 1.31–1.87), and rural residence (aOR = 1.36, 95% CI: 1.18–1.58) were significantly associated with higher odds of unmet healthcare needs. Among the need factors, fall experience (aOR = 1.56, 95% CI: 1.34–1.83), pain or discomfort (aOR = 2.40, 95% CI: 1.93–2.99), and elevated stress (aOR = 2.37, 95% CI: 2.02–2.79) were also significantly associated with unmet healthcare needs. Conclusions: Beyond accessibility, unmet healthcare needs among older adults with osteoporosis in Korea were associated with cognitive, health-related, and regional factors. Interventions should prioritize improving health literacy, managing pain and psychological distress, and strengthening osteoporosis care pathways, specifically focusing on follow-up care and fragility fracture prevention.