Background and objectives: More nutritious diets, as reflected in greater food diversity, is important to elderly health and survivorship. However, it is unclear how this factor affects medical costsTe aim of this study is to assess dietary quality using a dietary diversity score (DDS) and evaluate the association between DDS and medical service utilization and expenditure. Methods: Tis study evaluates the DDS (range: 0-6) of the Elderly Nutrition and Health Survey in Taiwan (1999-2000) using a 24-h dietary recall design. We linked 1781 elders to National Health Insurance (NHI) claims, excluding those with no NHI records or with catastrophic illness history; 1650 elders were eligible. Generalized linear models were used to appraise the association between DDS and annual medical utilization and expenditure. Results: Tose with a higher DDS had lower medical service utilization and expenditure for emergencies and hospitalization. Aſter adjustment for potential confounders, emergency and hospitalization expenditures for elders with DDS = 6 were lower than those with DDS≤3. However, for preventive care and dental services, a higher DDS predicted greater utilization (0.25 and 0.5 times) and expenditure (270 and 420 NTD). Findings remained unchanged when those who died in the first year or had any medical utilizations and expenditure one year prior to death were excluded. Conclusions: Greater dietary diversity is associated with lower emergency and hospitalization utilization and expenditure, but not ambulatory services. Tere is a need for nutrition policy in health services for nutritionally disadvantaged groups.
Date:
2013-09
Relation:
Annals of Nutrition and Metabolism. 2013 Sep;63(Suppl. 1):692.
