What the Research Says


 
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In the Food=Medicine study with Project Open Hand, 59.6% of the participants were affected by food insecurity in the beginning of the pilot. By the follow-up, food insecurity decreased to 11.5%.

  • The study also helped decrease other negative factors pertaining to health like the intake of fatty foods (from 3.19 time per day to 2.21), sugary foods (p=0.07) and drinks (from 0.994 to 0.650), binge drinking (from 26.0 to 13.5%), smoking (from 44.2 to 38.5%), substance abuse and hazardous drinking (from 17.3 to 13.5%),

  • The follow-up showed fewer depressive symptoms in the participants (from 7.58 to 5.84), giving up healthcare for food (from 34.6 to 19.2%), giving up food for healthcare (from 38.5% to 19.2%) or purchasing prescriptions (from 28.9 to 15.4%).

Palar, K., Napoles, T., Hufstedler, L. L., Seligman, H., Hecht, F.M., Madsen, K., Ryle, M., Pitchford, S., Frongillo, E.A., Welser, S.D. (2017).  Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health. J Urban Health, 87-99.


A MANNA study resulted in an automatic decrease in healthcare cost after clients received services.

  • The total cost for all MANNA patient decreased monthly cost (from $38,937 to $28,183).

  • The average monthly inpatient cost decreased after 3 months (from $174,320 to 121,777).

  • The average monthly cost for MANNA clients decreased to $28,183 while the NON-MANNA clients cost averaged to be $41,000 (55% difference).

  • Hospital admissions and stay were lower in cost for the MANNA clients in comparison to the NON-MANNA Clients ($132,000 vs. $220,000).

  • 93% of MANNA clients who were inpatient hospitalization returned home, compared to 72% of NON-MAANA clients who were discharged to an acute care facility.

  • MANNA client’s hospital stay was 37% shorter than the NON-MANNA clients.

Gurvey, J., Rand, K., Daugherty, S., Dinger, C., Schmeling, J., Laverty, N. (2013). Examining Health Care Costs Among MANNA Clients and a Comparison Group. Journal of Primary Care & Community Health 4(4) 311-317.


The Simply Delivered for ME (SDM) study discovered 30-day readmission rates for 622 discharge patients decreased 10.3% after 24 months. 16.3% lower than patient solely obtaining Community-based Care Transition programs (CCTP).

Martin, S.L., Connelly, N., Parsons, C., Blackstone, K. (2018). Simply Delivered Meals: A Tale Of Collaboration. The American Journal of Managed Care, 301-304.


Meals on wheels orchestrated a study in regards to the knowledge of home-delivered meals in Auckland, New Zealand. The study showed that a majority of health professionals expressed the Meals on Wheels menu did not cater to the various cultures found in NZ, which was suggested to be difficult or costly.

Wilson, A., Dennison, K. (2011). Meals on Wheels services: Knowledge and perceptions of health professionals and older adults. Journal of the Academy of Nutrition and Dietetics, 155-160.


MEND study states: “Conducting a randomized controlled trial to assess the outcomes of providing home-delivered meals to older adults after discharge from the hospital in partnership with a small nonprofit organization is feasible.”

  • 1 in 6 Medicare patients are readmitted after medical care. 1 in 8 after surgery.

  • Malnutrition occurs in 20% to 70% of older adults who are hospitalized, up to 40% of older adults recently discharged from the hospital.

Buys, D.R, Campbell, A.D., Godfryd, A., Flood, K., Kitchin, E., Kilgore, M.L., Allocca, S., Locher, J.L. (2017). Meals Enhancing Nutrition after Discharge (MEND): Findings from a Pilot Randomized Controlled Trial. Journal of the Academy of Nutrition and Dietetics, 599-608.


 “The common health problem in older adults is poor nutrition or under-nutrition: it is reported that global malnutrition occurs in 15%-50% of older adults.”

Jeong-Ah, A., JeeWon, P., Chun-Ja, K. Effects of an individualized nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of older adults living alone. Wiley Journal of Clinical Nursing, 2142-2151.

 

Community Servings (in partnership with AARP and Massachusetts General Hospital) conducted a study to determine if medically tailored and non-medically tailored meal deliveries could have a positive association with food insecurity, ED visits, and “Big Ticket” health services (inpatient admissions and emergency transportation) reduction.

  • Medically tailored meals revealed lower percentages in all aspects compared to control group A. Fewer ED visits(adjusted incidence rate ratio: 0.30; 95% confidence interval: 0.20, 0.45), inpatient admissions (aIRR: 0.48; 95% CI: 0.26, 0.90), and use of emergency transportation ( aIRR: 0.28; 95% CI: 0.16, 0.51).

  • Non-medically tailored meals had a similar outcome compared to control group B. Fewer ED visit ( aIRR: 0.56; 95% CI:0.47, 0.68), use of emergency transportation (aIRR: 0.62; 95% CI: 0.49, 0.78), however didn’t show a reduction in inpatient admissions.

  • Participants in the medically tailored program and the non-medically tailored program were associated with lower medical spending.

  • Medically tailored meals displayed a difference of $570 compared to the control group, and non-medically tailored meals displayed a difference of $156 compare to the control group.

Berkowitz, S.A, Terranova, J., Hill, C., Ajayi, T., Linsky, T., Tishler, L.W., DeWalt, D.A. (2018). Meal Delivery Porgrams Reduce The Use Of Costly Health Care In Dually Eligible Medicare And Medicaid Beneficiaries. 


A 2009 survey of home-delivered meals program recipients found that 59 percent of the recipients seventy-five or older reported that home-delivered meals program provided at least half of their daily intake.

  • 59 percent of recipients were 65 and older, and reported home-delivered meal programs provided at least half of their daily intake.

  • 4 out of 10 home-delivered meal program recipients reported requiring assistance involving 1 or more of the 5 core activities pertaining to daily living (bathing, dressing, eating, utilizing the restroom, and transferring into or out of bed or a chair.

  • Increasing the population of individuals who receive home-delivered meals by 1 percent, conveyed a decrease in the state’s low-caring nursing home population.

  • Home-delivered meal programs would increase initial savings to Medicaid programs. Exceeding $109 million for the country as a whole.

  • 92 percent of home-delivered meal program recipients stated the meals enabled them to continue living in their homes.  

Thomas, K.S., Mor, Vincent. (2013). Providing More Home-Delivered Meals Is One Way To Keep Older Adults With Low Care Needs Out of Nursing Homes. Health Affairs, 1796-1802.


85% of chronic diseases and disabilities among older adults (60 and older) can be mitigated with adequate nutrition.

Jeong-Ah, A., JeeWon, P., Chun-Ja, K. Effects of an individualized nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of older adults living alone. Wiley Journal of Clinical Nursing, 2142-2151.


By conducting meal-delivery to near-poor older adults (65+), it provides the socialization and “safety check” performed by the delivery person.

Thomas, K.S., Akobundu, U., Dosa, D. (2015). More Than A Meal? A Randomized Control Trial Comparing the Effects of Home-Delivered Meals Programs on Participants’ Feelings of Loneliness. Journals of Gerontology: Social Sciences, 1049-1058.   AND

Kali, T.S, Mor, V. (2013). The relationship between Older Americans Act Title III State Expenditures and Prevalence of Low-Care Nursing Home Residents. HSR: Health Research and Educational Trust, DOI:10.1111/1475-6773.12015


“A Steady shift upward in enrollment from the Original Medicare plan to Medicare Advantage plans has taken place since 2005 with 30% of enrollees now opting for private insurance instead of the traditional fee-for-service option”.

  • Meal-delivery mainly caters to older adults and individuals with chronic illness. In 2010 40 million adults were over the age of 65 (13%). By 2030, older adults will be 20% of the population.

Campbell, A.D., Godfryd, A., Buys, D.R, Locher, J.L. (2015). Does Participation in Home-delivered Meals Programs Improve Outcomes for Older Adults? Results of a Systematic Review. J Nutria Gerontology Geriatric, 124-167


60% of Medicare reimbursements come from adults ages 65 and older. These adults are diagnosed with congestive heart failure and readmitted within 6 months of being hospitalized.

Phillips, C.O, Wright, S.M., Kern, D.E., Singa, R., Shepperd, S., Rubin, H.R. (2004). Comprehensive Discharge Planning with Post discharge Support for Older Patients with Congestive Heart Failure. JAMA Vol 291, No.11


Prepared by Andreana Banks, University of San Francisco MPH Student Intern