MEALS ON WHEELS UTILIZATION AND THE RISK OF HOSPITALIZATION AMONG MEDICARE ENROLLEES OVER TIME

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.