Nutrition and Health for Older Persons in Rural America: A Managed Care Model

Health care services and resources for older persons living in rural areas may be highly variable, and integrated service-delivery models are often lacking. This article presents a managed-care model of nutrition risk screening and intervention for older persons in rural areas. Nutrition risk screen...

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Bibliographic Details
Published in:Journal of the American Dietetic Association 1997-08, Vol.97 (8), p.885-888
Main Authors: KLEIN, GLORIA L., KITA, KIMBERLY, FISH, JUDITH, SINKUS, BARBARA, JENSEN, GORDON L.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Case Management - organization & administration
dietitians
elderly
Evaluation
Health aspects
health services
Health Status
Human physiology applied to population studies and life conditions. Human ecophysiology
Humans
malnutrition
Managed Care Programs - organization & administration
Medical care
Medical sciences
Medical screening
Models, Organizational
Nutrition
nutrition assessment
Nutrition counseling
nutritional intervention
Nutritional Status
Nutritional survey. Food supply and nutritional requirement
Older people
Pennsylvania
physicians
risk assessment
Rural areas
Rural Health Services - organization & administration
screening
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Summary:Health care services and resources for older persons living in rural areas may be highly variable, and integrated service-delivery models are often lacking. This article presents a managed-care model of nutrition risk screening and intervention for older persons in rural areas. Nutrition risk screening was implemented by the Geisinger Health Care System, Danville, Pa, to target all eligible enrollees in a regional Medicare risk program. A single remote clinic site participating in the managed health care system was chosen for further study of a linked screening and case-management effort for undernourished persons. Screening and intervention at the clinic site selected for this study were guided by centralized expertise and resources. Individualized evaluation and intervention plans were developed with the aid of a dietitian and implemented by the clinic case manager. Of the 417 subjects who completed screening at the remote site, 68 met the risk criteria for undernutrition and were selected for case management. Many of the targeted persons received interventions that included evaluations by a physician or physician extender (eg, physician assistant, nurse practitioner) at the clinic and consultations with nutrition, mental health, or social services professionals. Twenty-six of the subjects who took part in the intervention completed a follow-up screening 6 months later. Ten of those persons no longer exhibited risk criteria. This demonstrates the feasibility of a linked screening and case management program for nutrition risk in the managed-care setting. J Am Diet Assoc. 1997; 97: 885-888.
ISSN:0002-8223
2212-2672
1878-3570
2212-2680
DOI:10.1016/S0002-8223(97)00216-2