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


Journal

Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027

Informations de publication

Date de publication:
03 2019
Historique:
pubmed: 13 7 2018
medline: 14 6 2019
entrez: 13 7 2018
Statut: ppublish

Résumé

Access to social services (eg, nutrition) can impact older adults' health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited. To link Meals on Wheels (MOW) program data to Medicare claims to enable examination of clients' health and health care utilization and to highlight the utility of this linked dataset. Using probabilistic linking techniques, we matched MOW client data to Medicare enrollment and claims data. Descriptive information is presented on clients' health and health care utilization before and after receiving services from MOW. In total, 29,501 clients were from 13 MOW programs. Clients' demographics, chronic conditions, and hospitalization, emergency department (ED), and nursing home (NH) utilization rates. We obtained a one-to-one link for 25,279 clients. Among these, 14,019 were Medicare fee-for-service (FFS) beneficiaries and met inclusion criteria for additional analyses. MOW clients had high rates of chronic conditions (eg, almost 90% of FFS clients were diagnosed with hypertension, compared with 63% of FFS beneficiaries in their communities). In the 6 months before receiving MOW services, 31.6% of clients were hospitalized, 24.9% were admitted to the ED and 13% received care in a NH. In the 6 months after receiving meals, 24.2% were hospitalized, 19.3% were admitted to the ED, and 9.5% received care in a NH. 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.

Sections du résumé

BACKGROUND
Access to social services (eg, nutrition) can impact older adults' health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited.
OBJECTIVES
To link Meals on Wheels (MOW) program data to Medicare claims to enable examination of clients' health and health care utilization and to highlight the utility of this linked dataset.
RESEARCH DESIGN
Using probabilistic linking techniques, we matched MOW client data to Medicare enrollment and claims data. Descriptive information is presented on clients' health and health care utilization before and after receiving services from MOW.
SUBJECTS
In total, 29,501 clients were from 13 MOW programs.
MEASURES
Clients' demographics, chronic conditions, and hospitalization, emergency department (ED), and nursing home (NH) utilization rates.
RESULTS
We obtained a one-to-one link for 25,279 clients. Among these, 14,019 were Medicare fee-for-service (FFS) beneficiaries and met inclusion criteria for additional analyses. MOW clients had high rates of chronic conditions (eg, almost 90% of FFS clients were diagnosed with hypertension, compared with 63% of FFS beneficiaries in their communities). In the 6 months before receiving MOW services, 31.6% of clients were hospitalized, 24.9% were admitted to the ED and 13% received care in a NH. In the 6 months after receiving meals, 24.2% were hospitalized, 19.3% were admitted to the ED, and 9.5% received care in a NH.
CONCLUSIONS
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.

Identifiants

pubmed: 30001250
doi: 10.1097/MLR.0000000000000951
pmc: PMC6349554
mid: NIHMS993310
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e15-e21

Subventions

Organisme : HSRD VA
ID : CDA 14-422
Pays : United States
Organisme : HSRD VA
ID : CDA 14-422
Pays : United States

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Auteurs

Mingyang Shan (M)

Brown University School of Public Health.

Roee Gutman (R)

Brown University School of Public Health.

David Dosa (D)

Brown University School of Public Health.
US Department of Veterans Affairs Medical Center, Providence, RI.

Pedro L Gozalo (PL)

Brown University School of Public Health.
US Department of Veterans Affairs Medical Center, Providence, RI.

Jessica A Ogarek (JA)

Brown University School of Public Health.

Sarah Kler (S)

Brown University School of Public Health.

Kali S Thomas (KS)

Brown University School of Public Health.
US Department of Veterans Affairs Medical Center, Providence, RI.

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