MEDICA@MUSC (Medical University of South Carolina)
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Food Deserts Impact on Hospital Admissions in Malnourished Patients Residing in Florida
Get PDFObjective: The primary objective of this study is to evaluate the impacts of food deserts on hospital admissions for individuals residing in the state of Florida.
Methods: The study design is a retrospective research cohort study analysis of Healthcare Cost Utilization Project (HCUP) data. Inpatient data for the entire state of Florida will be utilized. ICD 10 codes were used to identify malnutrition to evaluate health care utilization by zip code using a geospatial analysis identifying areas known to be food deserts based on United States Department of Agriculture (USDA) designated food census tracts. The data was accessed for the calendar year of 2018, which will offer the most recent complete hospital admissions data for Florida (HCUP, 2022).
Results: This study includes data for 540,278 individuals. Older adults (65 years of age and older) are 73% more likely than younger adults to have an admission to an acute care hospital due to malnutrition while residing in a non-food desert and 29% more likely while residing in a food desert. The 65 years of age and older population while residing in food deserts have 16.8% increase in odds to be admitted to a hospital for malnutrition. There is a statistically significant higher prevalence of obesity in older adults residing in a food desert, and lower length of stay combined with a higher rate of septicemia.
Conclusion: Residing in a Florida zip code designated as 100% food desert correlates with worse health outcomes and greater social risk factors. Addressing food insecurity, screening for malnutrition, and improving the effectiveness of state and national programs for those residing in food deserts could address the over utilization and poor outcomes associated with food deserts and community-based malnutrition
Characterizing Pediatric Unilateral Brain Damage: Unilateral Spatial Neglect, Balance, and More
Get PDFPediatric unilateral brain damage is a costly, impactful condition. There are many subsequent impairments that children experience after pediatric unilateral brain damage, two of which are unilateral spatial neglect (USN) and balance impairments. This project aims to compile the existing literature regarding USN in children, analyze insurance billing data to characterize the population, and evaluate balance and USN in a small case-control cohort of children with and without unilateral brain damage. The literature search elucidated the scant literature available addressing USN, including a lack of quality assessments to definitively identify USN. Insurance billing analyses showed an incredibly heterogeneous group, very little identifiable rehabilitation, high cost of medical care, and very little imaging. In a case-control cohort, there were qualitative differences in the way balance is measured between assessments, as well as how children with and without unilateral brain damage visually interpret the world around them. These findings will likely lead to future studies to develop assessments appropriate for this population, investigations into the role of vision and perception in development, and rehabilitation utilization studies. As this population continues to grow, both in age and in number, research to help children lead full, fulfilling lives will remain an important scientific interest