Improving malnutrition care to reduce health disparities in older adults

What is it about?

This article explores how improving inpatient malnutrition care can help address health disparities among older adults, particularly within underserved populations. Malnutrition affects over 30% of hospitalized patients, but it is often underdiagnosed and untreated—especially among racial and ethnic minorities, low-income groups, and rural communities. These groups also face higher rates of food insecurity, which further increases the risk of malnutrition. The article highlights the Malnutrition Quality Improvement Initiative (MQii), a national effort to standardize and improve hospital-based nutrition care using clinical quality measures. The initiative emphasizes early identification, proper assessment by registered dietitian nutritionists (RDNs), documentation, and creation of personalized care plans. Hospitals participating in the MQii Learning Collaborative have implemented tools like the Global Malnutrition Composite Score, which tracks four key components of inpatient malnutrition care. Through examples from WellStar Health System and UNC Health, the article shows how hospitals can screen for both malnutrition and food insecurity, refer patients to community resources, and tailor services to meet cultural and dietary needs. The article argues that integrating quality nutrition care with community-based support can not only improve patient outcomes but also reduce inequities tied to age, race, income, and geography.

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Why is it important?

Malnutrition significantly affects the health and recovery of older adults, leading to longer hospital stays, higher readmission rates, and increased mortality. These risks are magnified in underserved populations, who often face food insecurity and reduced access to healthcare and nutrition services. By identifying and addressing malnutrition during hospitalization, health systems have a unique opportunity to reduce these disparities and improve long-term outcomes. This article underscores that without standardized care processes, many patients—especially in minority and rural populations—are left undiagnosed and untreated. The MQii and its Global Malnutrition Composite Score offer hospitals a framework to consistently track, diagnose, and treat malnutrition. Data from participating hospitals reveal clear racial, ethnic, and geographic disparities in malnutrition diagnosis and outcomes, highlighting the urgency for targeted interventions. Furthermore, malnutrition screening offers a gateway to identifying food insecurity, a social determinant of health with profound effects on physical and mental well-being. By connecting hospitalized patients to local food resources and federal nutrition programs upon discharge, hospitals can extend care beyond their walls. Addressing inpatient malnutrition is not just a clinical priority—it’s a public health strategy to reduce systemic inequities and support vulnerable older adults through evidence-based, community-connected care. --------------------------- Some of the content on this page has been created using generative AI.