A New Data Resource to Examine Meals on Wheels Clients’ Health Care Utilization and Costs

Shan, Mingyang; Gutman, Roee; Dosa, David; Gozalo, Pedro; Ogarek, Jessica; Kler, S; Thomas, Kali S.

doi:10.1097/mlr.0000000000000951

Cited by 17 publications

(15 citation statements)

References 17 publications

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“…While this may seem counterintuitive, it is possible that other supports or characteristics help the oldest county residents meet their nutrition needs. This older age group may have greater access to home-delivered meals such as Meals on Wheels ( 49 ). Those who are not homebound may attend senior centers or adult day cares where they can partake in congregate or individual meals.…”

Section: Discussionmentioning

confidence: 99%

County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas

Bergeron

John

Sribhashyam

et al. 2021

The Journal of nutrition, health and aging

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Objectives This study aims to identify older adult malnutrition in Texas, examine county-level characteristics associated with crude malnutrition death rates, and describe assets and opportunities available to address and improve malnutrition among the older population. Design Secondary data analysis using the Centers for Disease Control and Prevention’s WONDER online database, the U.S. Census 2014–2018 American Community Survey, and the U.S. Department of Agriculture’s Food Access Research Atlas data. Setting All 254 counties in the state of Texas. Participants Individuals aged 65 years and older. Measurement The dependent variable was the proportion of county-level malnutrition crude death rates. Independent variables included Health Provider Shortage Area designations, rurality, poverty status, food access, age, race, ethnicity, and education. Results The overall malnutrition crude death rate in Texas was 65.6 deaths per 100,000 older Texans, ranging from 0 to 414.46 deaths per 100,000 depending on the county. Higher malnutrition crude death rates were associated with non-metropolitan counties (P=0.018), lower education (P=0.047), greater household poverty (P=0.010), and low food access (P<0.001). Conclusion Socioeconomic disadvantages at the county-level appear to be one of the root causes of malnutrition crude death rates in Texas.

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Section: Discussionmentioning

confidence: 99%

County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas

Bergeron

John

Sribhashyam

et al. 2021

The Journal of nutrition, health and aging

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“…One limitation to integrating technological services with the HDMP is the insufficient funding of the HDMP by the OAA [5,27]. The OAA covers less than a quarter (23%) of the total cost to provide meals, safety checks, and visits to over 174,000 seniors [28].…”

Section: Discussionmentioning

confidence: 99%

Characterizing Intervention Opportunities Among Home-Delivered Meals Program Participants: Results From the 2017 National Survey of Older Americans Act Participants and a New York City Survey

et al. 2020

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Background: The Home Delivered Meals Program (HDMP) serves a vulnerable population of adults aged 60 and older who may benefit from technological services to improve health and social connectedness. Objective: The objectives of this study are (a) to better understand the needs of HDMP participants, and (b) to characterize the technology-readiness and the utility of delivering information via the computer. Design: We analyzed data from the 2017 NSOAAP to assess the health and functional status and demographic characteristics of HDMP participants. We also conducted a telephone survey to assess technology use and educational interests among NYC HDMP participants. Measurements: Functional measures of the national sample included comorbidities, recent hospitalizations, and ADL/IADL limitations. Participants from our local NYC sample completed a modified version of the validated Computer Proficiency Questionnaire. Technology readiness was assessed by levels of technology use, desired methods for receiving health information, and interest in learning more about virtual senior centers. Results: About one-third (32.4%) of national survey HDMP participants (n=902) reported insufficient resources to buy food and 17.1% chose between food or medications. Within the NYC HDMP participant survey sample (n=33), over half reported having access to the internet (54.5%), 48.5% used a desktop or laptop, and 30.3% used a tablet, iPad, or smartphone. Conclusion: The HDMP provides an opportunity to reach vulnerable older adults and offer additional resources that can enhance social support and improve nutrition and health outcomes. Research is warranted to compare technological readiness of HDMP participants across urban and rural areas in the United States.

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“…10,11 Although client satisfaction was not directly assessed, feedback from care coordinators suggests clients were receptive to assistance and that connections were made with outside resources who may have been able to meet clients' needs and enable them to retain their independence. This could be because the client only needed information from the care coordinator or was already in the process of obtaining services.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7] Taken together with health behaviors, these social, economic, and environmental conditions are associated with up to 80% of one's health and health outcomes, including mortality. 9 This association may be particularly pronounced among vulnerable populations, such as homebound older adults (ie, persons 65 years and older), who, in addition to being medically complex, 10,11 often have a variety of unmet health-related social needs and may require additional assistance to maintain their functional independence. 9 This association may be particularly pronounced among vulnerable populations, such as homebound older adults (ie, persons 65 years and older), who, in addition to being medically complex, 10,11 often have a variety of unmet health-related social needs and may require additional assistance to maintain their functional independence.…”

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confidence: 99%

Leveraging Home‐Delivered Meal Programs to Address Unmet Needs for At‐Risk Older Adults: Preliminary Data

Morris

Engelberg

Schmitthenner

et al. 2019

J American Geriatrics Society

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BACKGROUND Home‐delivered meal programs serve a predominantly homebound older adult population, characterized by multiple chronic conditions, functional limitations, and a variety of complex care needs, both medical and social. DESIGN A pilot study was designed to test the feasibility of leveraging routine meal‐delivery service in two home‐delivered meal programs to proactively identify changes in older adult meal recipients’ (clients’) health, safety, and well‐being and address unmet needs. INTERVENTION Meal delivery personnel (drivers) were trained to use a mobile application to submit electronic alerts when they had a concern or observed a change in a client's condition. Alerts were received by care coordinators, who followed up with clients to offer support and help connect them to health and community services. RESULTS Over a 12‐month period, drivers submitted a total of 429 alerts for 189 clients across two pilot sites. The most frequent alerts were submitted for changes in health (56%), followed by self‐care or personal safety (12%) and mobility (11%). On follow‐up, a total of 132 referrals were issued, with most referrals for self‐care (33%), health (17%), and care management services (17%). Focus groups conducted with drivers indicated that most found the mobile application easy to use and valued change of condition monitoring as an important contribution. CONCLUSION Findings suggest that this is a feasible approach to address unmet needs for vulnerable older adults and may serve as an early‐warning system to prevent further decline and improve quality of life. Efforts are underway to test the protocol across additional home‐delivered meal programs. J Am Geriatr Soc 67:1946–1952, 2019

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A New Data Resource to Examine Meals on Wheels Clients’ Health Care Utilization and Costs

Abstract: Linking MOW data to Medicare claims has the potential to shed additional light on the relationships among social services, health status, health care use, and benefits to clients' well-being.

Cited by 17 publications

References 17 publications

County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas

County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas

Characterizing Intervention Opportunities Among Home-Delivered Meals Program Participants: Results From the 2017 National Survey of Older Americans Act Participants and a New York City Survey

Leveraging Home‐Delivered Meal Programs to Address Unmet Needs for At‐Risk Older Adults: Preliminary Data

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