Abstract Body (Do not enter title and authors here): Abstract
Rationale
Food insecurity impacts millions of households in the United States and can be a strong predictor of poor mental and physical health, as well as avoidable chronic health conditions. Patients with food insecurity tend to have increased healthcare utilization and costs when compared to those without. To help alleviate this need, several healthy foods centers (HFCs) were established within a local hospital network to provide immediate food access to patients screening positive for food insecurity, as well as health-focused education on nutrition (e.g., impacts on HbA1C and cholesterol), budgeting, and meal preparation. We sought to conduct a preliminary examination to understand if the services provided by the HFCs were associated with improved healthcare utilization and costs, with an emphasis on utilization pertaining to cardiometabolic illness.
Methods
We conducted a pilot retrospective review of the electronic medical records and claims data, for adult patients who were referred to HFCs between 2019 and 2023. Patients in the intervention (visited an HFC at least once) and control (referred but did not visit any HFC) groups needed at least 8 months of continuous enrollment (6 months baseline and ≥2 months following their first HFC visit or referral date) to assess outcomes. Difference-in-differences regression models were used to identify any changes in emergency department (ED) visits, total costs of care, and cardiometabolic disease-specific savings after controlling for baseline differences between groups.
Results
Most patients were female (68%), white (65%), and single (39%), with an average age of 55 years. The intervention group averaged 4.8 visits to the HFC. The intervention group relative to the control group from baseline to follow-up saw average benefits of $579 in unadjusted ED costs and $2040 in unadjusted total costs. Effect sizes trended towards savings, though not initially statistically significant following covariate adjustment. Savings within the sample varied by overall medical complexity, with the highest benefits seen among those managing multiple chronic illnesses; savings were also higher when evaluating disease-specific spend.
Conclusions
Results of this pilot study for patients referred and seen in the HFC compared to the patients referred and not seen, suggest improvements in ED and total costs may be present with healthy food center interventions, with the greatest benefit among the sickest of the population.