- Design
- Retrospective cohort, single health system
- Population
- 368 adults aged ≥60 at risk of food insecurity, discharged home
- Primary outcome
- Unplanned readmission at 14, 21 and 30 days
- Effect
- 14-day aOR 0.31 (95% CI 0.14–0.69); 30-day aOR 0.82 (0.44–1.53)
A single-system retrospective cohort followed 368 adults aged 60 or older, discharged home and judged at risk of food insecurity or malnutrition, who were referred to a state-funded programme delivering two weeks of meals. About 63% actually received meals.
Meal recipients had lower odds of unplanned readmission at 14 days (aOR 0.31) and 21 days (aOR 0.47), but by 30 days the difference was no longer significant. Delivery within nine days showed the strongest association with fewer 14-day readmissions.
This is an observational comparison between patients who did and did not receive meals after referral, and the reasons some did not, such as being unreachable or too unwell, may themselves predict readmission. The finding is a reason to ask about food at discharge and to test meal programmes properly, not proof they prevent readmission. In India, the equivalent is often family support, which should be confirmed rather than assumed.
- Ask older patients before discharge who will shop and cook for them in the first fortnight.
- Screen for food insecurity and malnutrition as part of discharge planning.
- Refer to a meal or community nutrition service where one exists, and aim for delivery within the first week.
- Document the nutrition plan in the discharge summary so primary care can follow it up.
Why it matters
Food is rarely on the discharge checklist, yet the first two weeks home are when readmissions cluster.
Don't overread it
An association in a retrospective cohort; it cannot show that the meals prevented readmission.
The statistics, in plain English
An adjusted odds ratio of 0.31 means about a two-thirds lower odds of readmission at 14 days among meal recipients. The wide intervals and the fade by 30 days suggest the effect, if real, is short-lived, and the observational design cannot exclude healthier patients being more likely to receive meals.
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