TOP 45 - Medically Tailored Grocery Program

Publication Number: 1804.TOP 45

Virginia P. Evans, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Michelle Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Lindsey Arenberg, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Jill R. Krissberg, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Food insecurity (defined as limited access to nutritionally adequate food) is a social determinant of health that contributes to socioeconomic disparities in kidney disease. Proper nutrition is a mainstay treatment for managing dialysis complications, including hyperkalemia, hyperphosphatemia, & hypertension. Adopting fresh food & plant-based eating patterns while on dialysis improves short & long-term health outcomes. At our institution, 21% of children in the nephrology department live in food-insecure households. Studies show this contributes to poor dialysis outcomes, resulting in more infections & reduced quality of life. To address this, we created a Medically Tailored Grocery Program that provides kidney-appropriate nutrition via a bi-weekly home food delivery service to food-insecure children on dialysis.

Objective: This project is a matched cohort study designed to evaluate acute care utilization & outcome data for participants enrolled in the food-delivery service. We hypothesize that providing prescribed groceries to food-insecure children on dialysis will significantly decrease acute care utilization, especially hospitalizations related to infection or dialysis complications (e.g., hyperkalemia, fluid overload). Additionally, we hypothesize that participation in the program will help lower serum potassium & phosphorous levels for patients on dialysis.

Design/Methods: We will use a matched cohort design to evaluate the impact of the prescription grocery delivery program on acute care utilization (e.g., hospitalizations & ED visits) & clinical outcomes.

Intervention: Children (ages 2–21) receiving dialysis & cared for at our institution enrolled in the Grocery Program. Control: Children (ages 2–21) receiving dialysis & cared for at our institution identified as food insecure, prior to program implementation (before 2024). Group created from retrospective data.

Propensity score matching used to create a comparable control group. Variables for Matching: Age, sex, race/ethnicity, underlying diagnosis, zip code, payer, dialysis modality, and primary language.

Data Collection
•Acute care utilization: hospitalizations, ED visits, ICU stays, length of stay, diagnoses, & associated costs
•Laboratory markers: serum potassium, serum phosphorus

Statistical Analysis: Compare acute care utilization (hospitalizations, ED visits) & lab markers between intervention & matched control group. Assess preventable hospitalization costs to determine if Grocery Program is cost-saving. Two-sided p-value < 0.05 will be considered statistically significant. Data analysis & poster final by Jan.