Food Insecurity Status and Health Care Utilization Among COPD Patients: A Retrospective Study

Area of Science:

• Public Health
• Health Services Research
• Social Determinants of Health

Background:

• Current government programs for chronic disease patients primarily focus on clinical factors and patient education.
• These programs often overlook modifiable social determinants of health, such as food insecurity and homelessness, which can impact healthcare utilization.
• There is a need to evaluate the influence of social factors on health outcomes and healthcare system engagement.

Purpose of the Study:

• To investigate the relationship between food insecurity and sociodemographic variables.
• To assess differences in healthcare utilization, specifically emergency department visits and hospitalizations, among patients with chronic obstructive pulmonary disease (COPD) based on their food security status.

Main Methods:

• A descriptive, retrospective, cross-sectional study was conducted using electronic health records from 854 patients diagnosed with COPD.
• Data were analyzed using chi-square tests, t-tests, and multivariate logistic regression to identify factors associated with emergency department visits and hospitalizations.
• Participants were sampled from emergency departments of hospitals in Southern California.

Main Results:

• Significant differences were observed in food insecurity, age, race, medical insurance, zip code, homeless status, and smoking status between groups.
• Patients reporting food insecurity showed a significant association with increased emergency department visits (P=.033).
• No significant differences in hospitalizations were found between food-insecure and food-secure COPD patients (P=.592).

Conclusions:

• This research highlights the association between upstream social determinants of health (food insecurity, homelessness, zip code) and downstream health outcomes like repeated emergency department visits.
• Findings suggest that addressing social factors is crucial for effectively reducing healthcare utilization and improving patient outcomes.
• Existing healthcare programs can be leveraged to impact health outcomes by incorporating interventions for social determinants of health.