Vibha Bhargava

Food Insecurity and Medication Adherence in Low-Income Older Medicare Beneficiaries With Type 2 Diabetes

Little is known about diabetes management among low-income older Americans. This study used statewide self-administered survey and Medicare claims data to examine the relationships of food insecurity and medication (re)fill adherence in a sample of Medicare Part D beneficiaries with type 2 diabetes in need of food assistance in Georgia in 2008 (n = 243, mean age 74.2 ± 7.8 years, 27.2% African American, 77.4% female). (Re)fill adherence to oral hypoglycemics was measured as Proportion of Days Covered. Food insecurity was assessed using a six-item validated standard measure. About 54% of the sample were food insecure. About 28% of the diabetic sample did not (re)fill any diabetes medication and over 80% had at least one diabetes complication. Food insecure participants showed comparable (re)fill adherence to food secure participants. However, 57% of food insecure participants were nonadherent to oral hypoglycemics. Underlying basic needs must be addressed to improve diabetes management in this population.

Food Insecurity and Health Care Utilization Among Older Adults in the United States

ABSTRACT This study examined the relationships between food insecurity and utilization of four health services among older Americans: office visits, inpatient hospital nights, emergency department visits, and home health care. Nationally representative data from the 2011 and 2012 National Health Interview Survey were used (N = 13,589). Nearly 83.0% of the sample had two or more office visits, 17.0% reported at least one hospital night, 23.0% had at least one emergency room visit, and 8.1% used home health care during the past 12 months. Adjusting for confounders, food-insecure older adults had higher odds of using more office visits, inpatient hospital nights, and emergency department visits than food-secure older adults, but similar odds of home health care utilization. The findings of this study suggest that programs and policies aimed at reducing food insecurity among older adults may have a potential to reduce utilization of health care services.

Food Insecurity and Health Care Utilization Among Older Adults

This study examined the relationship between food insecurity and health care utilization (physician, inpatient, emergency room, and home health visits) among older adults. Survey data collected from Georgia Advanced Performance Outcomes Measures Project 6 linked to the Centers for Medicare and Medicaid Services (GA Advanced POMP6-CMS) data 2008 (N = 957) were analyzed. Nearly one half of the sample (48.3%) was food insecure. Food insecure individuals were significantly less likely than food secure individuals to have any physician (69.7% vs. 80.2%) and home health visits (24.9% vs. 32.3%) during 2008. However, there were no significant differences in levels of health care utilization by food secure and food insecure older adults. Food secure and food insecure older adults utilized comparable levels of health care services. Public assistance programs such as Medicare and meal services targeted toward older adults may enable economically constrained, food insecure older adults to access needed health care services.