The Opportunity for Quality Malnutrition Care to Improve Rural Health Outcomes and Health Equity for Older Americans

Abstract

Older adults have a heightened risk of malnutrition that occurs with age. Many factors can increase their risk for malnutrition, including factors associated with disease, function, social and mental health, and hunger and food insecurity. Risk for malnutrition is also linked to disparities and may disproportionately impact people living in rural areas. This Perspective paper outlines the issue of malnutrition and its impact on health outcomes and health disparities as well as summarizes existing evidence on malnutrition in rural healthcare institutions. Further it describes opportunities for malnutrition quality improvement and a new malnutrition quality measure, the Global Malnutrition Composite Score measure, that has recently been recommended by the National Quality Forum as a health equity measure for rural healthcare. The Perspective also suggests how this measure may help meet new health equity requirements of the Joint Commission and may help address needs identified in non-profit hospital community health needs assessments. The Perspective identifies resources for malnutrition quality improvement and the Composite measure, and shares key learnings from McPherson Hospital, a rural institution that has worked to improve malnutrition quality care. Finally, the Perspective suggests opportunities for rural healthcare institutions to better connect with community-based nutrition programs/services and recommends where more program development and policy support is still needed.