Food Insecurity in Patients with High Hospital Utilization
Food Insecurity in Patients with High Hospital Utilization
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DOI：
10.1089/pop.2015.0127
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发表时间：
2016-12-01
影响因子：
2.5
通讯作者：
Braitman, Leonard E.
中科院分区：
文献类型：
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作者：
Phipps, Etienne J.;Singletary, S. Brook;Braitman, Leonard E.
获得充足且合适的食物是一个重大的人口健康问题。本研究调查了住院率高的患者（过度使用者）的食物无保障情况。2015年3月至5月期间，在宾夕法尼亚州费城的一家城市医院对40名在12个月内有3次住院的成年人进行了访谈。住院病史从医院账单数据中获取。大多数人在过去12个月内有5次住院，且患有6种慢性病。根据美国农业部对食物无保障的定义，30%（95%置信区间，17% - 47%）的人存在食物无保障情况，25%（95%置信区间，13% - 41%）的人处于食物勉强有保障状态。40%的人回答说，在过去30天里，他们担心食物会耗尽；35%的人担心食物不够维持；17.5%的人一整天没吃东西；10%的人有时或一直饿着但没吃东西。此外，75%的人无法自己购买食物，58%的人无法自己准备食物。超过一半的人报告使用过食品救济站或其他社区食物资源。未满足的食物需求对医院过度使用的影响值得进一步研究。对有未满足食物需求的患者进行教育并将其与社区资源联系起来的干预措施，有助于患者关注自身的健康和幸福。与患者沟通他们是否有足够的适合其健康状况的营养食物是一个重要的起点。
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.