The impact of a nutrition counseling program on the use of hospital services for Meals on Wheels clients.

Home-delivered meals have shown considerable promise in overcoming nutritional challenges among homebound older adults facing food insecurity and the risk of diabetes, while nutrition counseling provides knowledge and skills for diabetes management. The purpose of this study was to identify the impact of a program combining nutrition counseling with home-delivered meals by examining the use of hospital services 6 months before and after participating in the program. This study included 1009 clients who are at risk for diabetes and who received home-delivered meals and nutrition counseling via Meals on Wheels in Fort Worth, Texas. Hospital service data were extracted from a regional claims database. Generalized linear models were performed to examine changes in use of hospital services 6 months before and after program participation. The mean number of emergency department visits and hospitalizations decreased from 0.69 to 0.50 (p < .001) and from 0.35 to 0.22 (p < .001), respectively. The findings of this study indicate that combining structured nutritional counseling with home-delivered meals may contribute to reducing healthcare use among older adults facing the challenges of diabetes and food insecurity.

A Model Home-Delivered Meals Program to Support Transitions from Hospital to Home.

Meals On Wheels, Inc. of Tarrant County (MOWI) collaborated with local community-based organizations and hospitals to provide home-delivered meals and an evidence-based medication management intervention as a care transition service. The model program was designed to address risk factors commonly associated with preventable hospital readmissions. MOWI staff provided meals to 121 patients recently discharged from an inpatient hospitalization or emergency department visit from March 2013 through March 2014. A total of 18,010 meals were delivered to the 121 clients. On average, clients received 6.25 meals per week with meal delivery starting, on average, 8.95 days postdischarge. Ninety-three of the 121 clients also elected to receive the HomeMeds program. Client self-report of health care utilization (e.g., hospital readmission) at three months and six months was lower than expected given client characteristics. Positive changes in the Emergent Care Assessment and resolution of medication alerts provide additional evidence of a positive effect of the home-delivered meals program. More research is needed to document the benefits of home-based care supports following hospitalization.