Food Insecurity and Healthcare Expenditures in Older Adults: Georgia Advanced Performance Outcomes Measures Project 2008 (GA POMP)

Abstract

Food insecurity is a persistent, growing, and clinically relevant problem in older adults, however its impact on healthcare expenditure is not known. This study examined the relationship of food insecurity with Medicare and out‐of‐pocket (OOP) expenditures in older Georgians enrolled in Medicare and meals services using two complementary datasets, GA POMP and 2008 Medicare claims data (n=903, mean age 76.9±7.8, 31.0 % male, 64.2% white). Due to the mixed distribution of healthcare expenditure data (e.g., high non‐users, right skewed distribution for users), two‐part models were used. More than half of the sample were food insecure (50.4%) and they were more likely to report poorer health status and to have chronic diseases than food insecure individuals. Food insecure older adults were less likely to incur any Medicare expenditure, but not any OOP expenditure than their counterparts. Among those who had any positive expenditure, food insecure compared with food secure individuals had similar Medicare expenditures, but lower OOP expenditures. In 2008, adjusted mean Medicare and OOP expenditures of food insecure individuals were $1,875 and $310 less than food secure individuals, respectively. These findings suggest complex relationships between food insecurity and healthcare expenditures in older adults reflecting unique healthcare access and usage patterns. This study was funded in part by US AoA and UGA.