title: Food Insecurity in Patients with High Hospital Utilization.
abstract: Having access to adequate and appropriate food is a major population health issue. This study investigated food insecurity in patients with high rates of inpatient hospitalization ("super-utilizers"). Forty adults with ≥3 hospital inpatient admissions within a 12-month period were interviewed in an urban hospital in Philadelphia, Pennsylvania, between March 2015 and May 2015. Inpatient admission history was obtained from hospital billing data. The majority had ≥5 hospitalizations in the past 12 months and ≥6 chronic conditions. Using the USDA definition of food insecurity, 30% (95% CI, 17% to 47%) were food insecure and 25% (95% CI, 13% to 41%) were marginally food secure. Forty percent responded that, in the past 30 days, they worried that their food would run out; 35% that their food would not last; 17.5% that they did not eat for a full day; and 10% that they were hungry but did not eat some or all of the time. Additionally, 75% were unable to shop for food on their own and 58% were unable to prepare their own food. More than half reported using food pantries or other community food resources. The impact of unmet food needs on hospital super-utilization warrants further investigation. Interventions that educate and connect patients with unmet food needs to community resources can help engage patients in their own health and well-being. Communication with patients about whether they have enough nutritionally appropriate food for their health conditions is an important starting point.
authors.affiliation: 1 Center for Urban Health Policy and Research , Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Etienne J
authors.initials: EJ
authors.lastname: Phipps
authors.affiliation: 2 Treatment Research Institute , Philadelphia, Pennsylvania.
authors.forename: S Brook
authors.initials: SB
authors.lastname: Singletary
authors.affiliation: 3 International Society for Pharmacoeconomics and Outcomes Research , Lawrenceville, New Jersey.
authors.forename: Clarissa A
authors.initials: CA
authors.lastname: Cooblall
authors.affiliation: 4 Department of Internal Medicine, Einstein Health Network , Philadelphia, Pennsylvania.
authors.forename: Horacio D
authors.initials: HD
authors.lastname: Hares
authors.affiliation: 5 Office of Technology and Development, Einstein Healthcare Network , Philadelphia, Pennsylvania.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Braitman
mesh_terms: D000368:Aged; D005260:Female; D005523:Food Supply; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015143:Philadelphia; D011203:Poverty; D036301:Qualitative Research