Food Insecurity Is Negatively Associated with Home Health and Out-of-Pocket Expenditures in Older Adults

Abstract

Food insecurity is a persistent, growing, and clinically relevant problem in older adults; however, its effect on healthcare expenditures is not known. This study examined the relationship of food insecurity with Medicare and out-of-pocket expenditures in older Georgians enrolled in Medicare and meal services using 2 complementary datasets: Georgia Advanced Performance Outcomes Measures Project 6 (GA Advanced POMP6) and Medicare claims data in 2008 (n = 903, mean age 76.9 ± 7.8 y, 31.0% male, 64.2% white). Due to the mixed distribution of healthcare expenditure data (e.g., high nonusers, right-skewed distribution for users), 2-part models were used. Approximately one-half of the sample was food insecure (50.4%) and was more likely to report poorer health status and to have chronic diseases than food-insecure individuals. Food-insecure older adults were less likely to have any Medicare expenditure than food-secure older adults. Among those who had positive Medicare expenditure, however, food-insecure and food-secure individuals had similar Medicare expenditures. Food-insecure and food-secure older individuals were equally likely to incur out-of-pocket expenditure. However, among those who had positive out-of-pocket expenditure, food-insecure older individuals had lower out-of-pocket expenditures than their counterparts. Adjusted mean Medicare and out-of-pocket expenditures of food-insecure individuals were $1875 and $310 less than food-secure individuals in 2008, respectively. These findings based on the innovative methodological approaches and datasets suggest complex relationships between food insecurity and healthcare expenditures in older adults, reflecting unique healthcare access and usage patterns.

Food Insecurity in Older Adults in an Integrated Health Care System

“…29,31,32 The one exception linked a state-level survey to Medicare claims. 30 We developed Model 1, based exclusively on clinical information, because it would be more easily replicable in other healthcare systems with electronic health records. Model 3, which combined clinical and survey data, more accurately identified a subpopulation of older adults at high risk of food insecurity (Table 3).…”

Association between household food insecurity and annual health care costs

“…Few studies have drawn on clinical measures of health status 10,20−23 or health services data, 16,19,24,25 and there has been no examination of the total burden of ill health associated with food insecurity or the implications for health care costs.…”

Incremental Health Care Costs Associated With Food Insecurity and Chronic Conditions Among Older Adults

“…Although previous studies estimated the health care costs for food-insecure adults (11–15), little research exists examining the health care costs associated with food insecurity and chronic health conditions among older adults. To address this gap, we estimated the incremental health care costs associated with food insecurity and the existence of selected chronic health conditions among older adults.…”