title: Undernutrition at baseline and health services utilization and mortality over a 1-year period in older adults receiving Medicare home health services.
abstract: OBJECTIVE
  Older adults receiving Medicare home health services who experience undernutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a 1-year period in older adults receiving Medicare home health services.
  
  
  METHODS
  This was a longitudinal study using questionnaires and anthropometric measures designed to assess nutritional status (Mini-Nutritional Assessment) at baseline and health services utilization and mortality status at 6-month and 1-year follow-ups.
  
  
  METHODS
  Participants were evaluated in their homes.
  
  
  METHODS
  A total of 198 older adults who were receiving Medicare home health services.
  
  
  RESULTS
  Based on Mini-Nutritional Assessment, 12.0% of patients were malnourished, 51.0% were at risk for malnourishment, and 36.9% had normal nutritional status. Based on body mass index, 8.1% of participants were underweight, 37.9% were normal weight, 25.3% were overweight, and 28.8% were obese. Using multivariate binary logistic regression analyses, participants who were malnourished or at risk for malnourishment were more likely to experience subsequent hospitalization, emergency room visit, home health aide use, and mortality for the entire sample and hospitalization and nursing home stay for overweight and obese participants.
  
  
  CONCLUSIONS
  Experiencing undernutrition at the time of receipt of Medicare home health services was associated with increased health services utilization and mortality for the entire sample, and with increased health services utilization only for the overweight and obese subsample. Opportunities exist to address risk of undernutrition in patients receiving home health services, including those who are overweight or obese, to prevent subsequent adverse health outcomes.
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294-2041, USA.
authors.forename: Yongbin
authors.initials: Y
authors.lastname: Yang
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Brown
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Kilgore
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
authors.forename: David L
authors.initials: DL
authors.lastname: Roth
authors.forename: Delia Smith
authors.initials: DS
authors.lastname: West
authors.forename: Julie L
authors.initials: JL
authors.lastname: Locher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000401:mortality*; D006278:Medicare; D008875:Middle Aged; D015596:Nutrition Assessment; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology