Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization among Older Adults? the Case of Maryland

Laura J Samuel, Sarah L Szanton, Rachel Cahill, Jennifer Wolff, Pinchuan Ong, Ginger Zielinskie, Charles Betley

Research output: Contribution to journalArticle

Abstract

This study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged ≥65 years who were dually enrolled in Medicare and Medicaid (2009-2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR = 0.99, 95% CI: 0.99-0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47% of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.

Original languageEnglish (US)
Pages (from-to)88-95
Number of pages8
JournalPopulation Health Management
Volume21
Issue number2
DOIs
StatePublished - Apr 1 2018

Fingerprint

Food Assistance
Hospital Emergency Service
Hospitalization
Hospital Costs
Medicaid
Odds Ratio
Confidence Intervals
Cost Savings
Hospital Departments
Medicare
Health Care Costs
Health Status
Inpatients
Delivery of Health Care

Keywords

  • food assistance
  • health care utilization
  • hospitalization
  • older adults
  • socioeconomic status

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization among Older Adults? the Case of Maryland. / Samuel, Laura J; Szanton, Sarah L; Cahill, Rachel; Wolff, Jennifer; Ong, Pinchuan; Zielinskie, Ginger; Betley, Charles.

In: Population Health Management, Vol. 21, No. 2, 01.04.2018, p. 88-95.

Research output: Contribution to journalArticle

@article{0ecc60326da149c4aa60a7de235ea81e,
title = "Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization among Older Adults? the Case of Maryland",
abstract = "This study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged ≥65 years who were dually enrolled in Medicare and Medicaid (2009-2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR] = 0.96, 95{\%} confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR = 0.99, 95{\%} CI: 0.99-0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47{\%} of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.",
keywords = "food assistance, health care utilization, hospitalization, older adults, socioeconomic status",
author = "Samuel, {Laura J} and Szanton, {Sarah L} and Rachel Cahill and Jennifer Wolff and Pinchuan Ong and Ginger Zielinskie and Charles Betley",
year = "2018",
month = "4",
day = "1",
doi = "10.1089/pop.2017.0055",
language = "English (US)",
volume = "21",
pages = "88--95",
journal = "Population Health Management",
issn = "1942-7891",
publisher = "Mary Ann Liebert Inc.",
number = "2",

}

TY - JOUR

T1 - Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization among Older Adults? the Case of Maryland

AU - Samuel, Laura J

AU - Szanton, Sarah L

AU - Cahill, Rachel

AU - Wolff, Jennifer

AU - Ong, Pinchuan

AU - Zielinskie, Ginger

AU - Betley, Charles

PY - 2018/4/1

Y1 - 2018/4/1

N2 - This study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged ≥65 years who were dually enrolled in Medicare and Medicaid (2009-2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR = 0.99, 95% CI: 0.99-0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47% of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.

AB - This study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged ≥65 years who were dually enrolled in Medicare and Medicaid (2009-2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR = 0.99, 95% CI: 0.99-0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47% of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.

KW - food assistance

KW - health care utilization

KW - hospitalization

KW - older adults

KW - socioeconomic status

UR - http://www.scopus.com/inward/record.url?scp=85045580080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045580080&partnerID=8YFLogxK

U2 - 10.1089/pop.2017.0055

DO - 10.1089/pop.2017.0055

M3 - Article

C2 - 28683219

AN - SCOPUS:85045580080

VL - 21

SP - 88

EP - 95

JO - Population Health Management

JF - Population Health Management

SN - 1942-7891

IS - 2

ER -