In a recent study, Duke University School of Medicine researchers found that providing two weeks of home-delivered meals to food-insecure older adults after hospital discharge was associated with significantly lower short-term hospital readmission rates.
The findings add to growing evidence that addressing food insecurity through “Food is Medicine” programs may improve recovery after hospitalization while helping reduce costly readmissions among vulnerable older adults.
The study, published in September in the Journal of Hospital Medicine, included 368 adults aged 60 years and older who had been discharged home from three hospitals within Duke University Health System between September 2022 and April 2024 and were at risk of food insecurity or malnutrition. The patients were referred to a state-funded Meals on Wheels hospital discharge pilot program that provided two weeks of home-delivered meals. Patients received one home-delivered meal per day for two weeks.
The researchers divided the patients into two groups for comparison: patients who received meals and patients who were referred but did not receive meals.
The patients who received meals were less likely to be readmitted to the hospital compared to the second group. Patients who received meals were readmitted about one-third as often within 14 days (4.6% vs. 12.8%) and about half as often within 21 days (7.1% vs. 14.2%) compared with patients who were referred but did not receive meals.
The study suggests that a relatively low-cost intervention such as this one may help reduce short-term readmissions among older adults experiencing food insecurity. The findings support previous research that says addressing basic needs such as access to food may improve health outcomes and support recovery after hospitalization.
“Patients who report health related social needs — whether that's not being able to get food, transportation barriers, housing scarcity, not able to pay for utilities or their mortgage on time — are at higher risk for readmission,” said Susan Spratt, MD, professor of medicine and senior author of the study. “And they're at higher risk for a host of other medical problems, including diabetes.
“We want to make sure everyone is fed in our community,” she said. “If we're going to improve health, our mission is to make sure that everyone has the highest level of health that they can obtain.”
Having access to nutritious meals after leaving the hospital can support healing and help patients manage chronic conditions, said Eugenia McPeek Hinz, MD, first and corresponding author of the study and assistant professor of medicine at Duke.
“During that immediate post discharge period, patients can put their energy toward healing as opposed to [focusing on] ‘I need to go find food,’” she said. “It gives them the ability to make sure that they're eating and still can have the opportunity to recover.”
The study also found that patients who received their first meal within nine days of discharge experienced the greatest benefit. Early meal delivery was associated with significantly lower 14-day readmissions compared with patients who never received meals.
According to McPeek Hinz, this finding suggests that the timing of support may be important and that future studies should examine whether faster delivery can further improve outcomes.
“Health systems working to reduce short-term readmissions could consider programs like this, and future studies should test whether faster or longer meal delivery improves outcomes further,” McPeek Hinz said.
The authors said a limitation of the study is that it cannot prove meals directly caused the reduction in readmissions because it was an observational study rather than a randomized clinical trial.
Next, they hope to explore whether timing and a longer‐duration meal delivery program could improve readmission rates.
Other Duke authors: Abby F. Hoffman, PhD; Michael Pignone MD, MPH; Tara Kinard DNP, MBA; Bradi B. Granger, PhD; Camille Grant Valentine, MHA; and Connor Drake PhD.