Together in Care: An Enhanced Meals on Wheels Intervention Designed to Reduce Rehospitalizations among Older Adults with Cardiopulmonary Disease—Preliminary Findings

Panagis Galiatsatos, Adejoke Ajayi, Joyce Maygers, Stephanie Archer Smith, Lucy Theilheimer, Sherita H. Golden, Richard G. Bennett and William Daniel Hale
Additional contact information
Panagis Galiatsatos: Office of Diversity and Inclusion, Johns Hopkins Health System, Baltimore, MD 21205, USA
Adejoke Ajayi: Department of Medicine, Medicine for the Greater Good, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA
Joyce Maygers: Office of Population Health, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA
Stephanie Archer Smith: Meals on Wheels, Baltimore, MD 21224, USA
Lucy Theilheimer: Meals on Wheels, Baltimore, MD 21224, USA
Sherita H. Golden: Office of Diversity and Inclusion, Johns Hopkins Health System, Baltimore, MD 21205, USA
Richard G. Bennett: Division of Geriatrics, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA
William Daniel Hale: Department of Medicine, Medicine for the Greater Good, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA

IJERPH, 2022, vol. 19, issue 1, 1-11

Abstract: Rehospitalizations in the Medicare population may be influenced by many diverse social factors, such as, but not limited to, access to food, social isolation, and housing safety. Rehospitalizations result in significant cost in this population, with an expected increase as Medicare enrollment grows. We designed a pilot study based upon a partnership between a hospital and a local Meals on Wheels agency to support patients following an incident hospitalization to assess impact on hospital utilization. Patients from an urban medical center who were 60 years or older, had a prior hospitalization in the past 12 months, and had a diagnosis of diabetes, hypertension, heart failure, and/or chronic obstructive pulmonary disease were recruited. Meals on Wheels provided interventions over 3 months of the patient’s transition to home: food delivery, home safety inspection, social engagement, and medical supply allocation. Primary outcome was reduction of hospital expenditure. In regard to the results, 84 participants were included in the pilot cohort, with the majority (54) having COPD. Mean age was 74.9 ± 10.5 years; 33 (39.3%) were female; 62 (73.8%) resided in extreme socioeconomically disadvantaged neighborhoods. Total hospital expenditures while the cohort was enrolled in the transition program were $435,258 ± 113,423, a decrease as compared to $1,445,637 ± 325,433 ( p < 0.01) of the cohort’s cost during the three months prior to enrollment. In conclusion, the initiative for patients with advanced chronic diseases resulted in a significant reduction of hospitalization expenditures. Further investigations are necessary to define the impact of this intervention on a larger cohort of patients as well as its generalizability across diverse geographic regions.

Keywords: community health; rehospitalizations; COPD; health disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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