Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization Among Older Adults? The Case of Maryland

被引:52
作者
Samuel, Laura J. [1 ]
Szanton, Sarah L. [2 ]
Cahill, Rachel [3 ]
Wolff, Jennifer L. [4 ]
Ong, Pinchuan [5 ]
Zielinskie, Ginger [3 ]
Betley, Charles [6 ]
机构
[1] Johns Hopkins Sch Nursing, Dept Acute & Chron Care, Baltimore, MD USA
[2] Johns Hopkins Sch Nursing, Dept Community Publ Hlth, Baltimore, MD USA
[3] Benefits Data Trust, Philadelphia, PA USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA
[5] Northwestern Univ, Dept Econ, Evanston, IL USA
[6] Univ Maryland Baltimore Cty, Hilltop Inst, Baltimore, MD 21228 USA
关键词
food assistance; health care utilization; hospitalization; older adults; socioeconomic status; EMERGENCY-DEPARTMENT VISITS; CARE-SENSITIVE CONDITIONS; FOOD INSECURITY; PREVENTABLE HOSPITALIZATIONS; MEDICATION NONADHERENCE; FINANCIAL STRAIN; HEALTH; RISK; RATES; NEEDS;
D O I
10.1089/pop.2017.0055
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
This study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged 65 years who were dually enrolled in Medicare and Medicaid (2009-2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR]=0.96, 95% confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR=0.99, 95% CI: 0.99-0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47% of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.
引用
收藏
页码:88 / 95
页数:8
相关论文
共 36 条
[1]  
Alley DE, 2015, NEW ENGL J MED, V374, P1
[2]   Treat or Eat: Food Insecurity, Cost-related Medication Underuse, and Unmet Needs [J].
Berkowitz, Seth A. ;
Seligman, Hilary K. ;
Choudhry, Niteesh K. .
AMERICAN JOURNAL OF MEDICINE, 2014, 127 (04) :303-+
[3]   Interruptions in Medicaid Coverage and Risk for Hospitalization for Ambulatory Care-Sensitive Conditions [J].
Bindman, Andrew B. ;
Chattopadhyay, Arpita ;
Auerback, Glenna M. .
ANNALS OF INTERNAL MEDICINE, 2008, 149 (12) :854-+
[4]   Preventable hospitalizations and socioeconomic status [J].
Blustein, J ;
Hanson, K ;
Shea, S .
HEALTH AFFAIRS, 1998, 17 (02) :177-189
[5]  
Buccaneer, 2012, CCW CHRONIC CONDITIO
[6]  
Farson Gray K, 2015, CHARACTERISTICS SUPP
[7]  
Farson Gray K, 2016, TRENDS SUPPLEMENTAL
[8]   Frailty in older adults: Evidence for a phenotype [J].
Fried, LP ;
Tangen, CM ;
Walston, J ;
Newman, AB ;
Hirsch, C ;
Gottdiener, J ;
Seeman, T ;
Tracy, R ;
Kop, WJ ;
Burke, G ;
McBurnie, MA .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2001, 56 (03) :M146-M156
[9]   Risk Factors for Early Hospital Readmission in Low-Income Elderly Adults [J].
Iloabuchi, Tochukwu C. ;
Mi, Deming ;
Tu, Wanzhu ;
Counsell, Steven R. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2014, 62 (03) :489-494
[10]  
Institute of Medicine, 2016, M DIET NEEDS OLD AD