Abstract
Abstract Meals on Wheels (MOW) services provide nutritional and social support for clients and may influence acute care use as a result. This study estimates the associations between MOW utilization and the risk of hospitalization for Medicare enrollees aged 65 and over, according to the degree of home-boundness (an eligibility criterion for MOW access). Attention is paid to the heterogenous role of MOW according to gender, race, and ethnicity. The analysis uses the 2014-2020 National Health and Aging Trends Study (NHATS) and includes 17,345 person-year observations. The study uses longitudinal complex survey Probit models of the likelihood of hospitalization, including interaction terms between lagged MOW usage and the extent of home-boundness. Control variables include sociodemographic indicators, living arrangements, health status, region and time fixed effects. Over the study period, the mean probability of hospitalization for Medicare enrollees aged 65+ is 20.5 percent, and the proportion of MOW users is 5.2 percent. Some 11.4 percent report being partially homebound and 5.6 percent mostly/fully homebound. Results reveal that MOW utilization is associated with a lower risk of hospitalization for those who are partly homebound (p= 0.058). This negative association is the largest and statistically significant for males (p=0.034) and whites (p=0.035) only. Further investigations will assess whether these associations are explained by differences between MOW and non-MOW users. The findings suggest that MOW services may delay or limit, to some extent, hospitalizations among partly homebound Medicare enrollees.
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