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Recovering successfully at home once discharged from the hospital can present a challenge to many seniors. Factors that are often unobservable in a clinical setting — such as the inability to regularly prepare nutritious meals, trying to manage complicated medication regimens and navigating in-home safety hazards — can lead to further health issues and injuries that land a senior back in the hospital for a longer and costlier recovery.
To help ease an individual’s return home after a stay in the hospital and prevent unnecessary readmissions, Meals on Wheels America, Johns Hopkins Bayview Medical Center and Meals on Wheels of Central Maryland launched a joint pilot program to provide services after hospitalization called Together in Care.
Participants were age 60 or older, had a hospitalization in the past 12 months, and had a diagnosis of diabetes, hypertension, heart failure and/or chronic obstructive pulmonary disease. Meals on Wheels provided three months of services over the patient’s transition to home post-hospitalization, including meal delivery, home safety inspection, social engagement and medical supplies.
Key Findings
Rehospitalizations are a significant source of health care costs among older adults, and this pilot study found that Meals on Wheels services can result in substantial cost savings in a short amount of time.
Total hospital expenditures declined by over $1 million, from $1,445,637 in the three months before enrollment to $435,258 in the three months after enrollment. Hospital admissions also significantly decreased, from 142 total hospital admissions before enrollment to 37 after enrollment.
One time I fell over, it was like a dead tree in a forest, and I was thinking, 'How am I gonna get up from this? It's changed everything for me. I haven't fallen since I have been back home.Together in Care participant
By using strategies that support older adults — like improving their access to food, making their homes safer and providing social support — we can help them stay healthier and avoid long hospital stays. While more research is needed, we believe that health systems should invest in this kind of care to help their patients and reduce costs.
External Publications
Together in Care: An Enhanced Meals on Wheels Intervention Designed to Reduce Rehospitalizations among Older Adults with Cardiopulmonary Disease—Preliminary Findings, Galiatsatos, P., Ajayi, A., Maygers, J., Archer Smith, S., Theilheimer, L., Golden, S. H., Bennett, R. G., & Hale, W. D., International Journal of Environmental Research and Public Health, 2022.
