title: Dietary diversity predicts type of medical expenditure in elders.
abstract: OBJECTIVE
  To assess the association between Dietary Diversity Scores (DDSs, range: 0-6 points) and medical service utilization and expenditures.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  The Elderly Nutrition and Health Survey in Taiwan (1999-2000) provided a 24-hour dietary recall for DDSs. National Health Insurance claims were linked for 1650 eligible elders. Generalized linear models were used to appraise the association between DDS and annual medical utilization and expenditures.
  
  
  RESULTS
  Those with a higher DDS had lower medical service utilization and expenditures for emergencies and hospitalization. After adjustment for potential confounders, emergency and hospitalization expenditures for elders with a DDS of 6 were lower than those with a DDS of 3 or lower. However, for preventive care and dental services, the highest DDS of 6 predicted greater utilization (0.25 and 0.5 times) and expenditure (270 and 420 Taiwanese new dollars). Findings remained unchanged when those who died in the first year or had any medical utilizations and expenditures1 year prior to death were excluded.
  
  
  CONCLUSIONS
  Greater dietary diversity is associated with lower emergency and hospitalization utilization and expenditures, but not lower use of ambulatory services. There is a need for health services to develop a nutrition policy for nutritionally disadvantaged groups.
authors: Yuan-Ting
authors: YT
authors: Lo
authors: Mark L
authors: ML
authors: Wahlqvist
authors: Yu-Hung
authors: YH
authors: Chang
authors: Senyeong
authors: S
authors: Kao
authors: School of Public Health, National Defense Medical Ct, 161 Minchuan East Rd, Sec 6, Taipei, Taiwan 114, Republic of China. E-mail: mmsl@ndmctsgh.edu.tw.
authors: Meei-Shyuan
authors: MS
authors: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D004032:Diet / Q000191:economics / Q000706:statistics & numerical data*; D004034:Diet Surveys; D058620:Elder Nutritional Physiological Phenomena; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology