How does a large health system learn about and improve social health integration?
研究了加州凯撒医疗的Medi-Cal医疗定制餐项目，评估其对营养不良患者的实施效果和满意度，发现项目在公平外展和健康改善方面有潜力，但餐食质量和多样性需改进。
Background:The Medi-Cal Medically Tailored Meals (MTM) program is one of 14 Community Supports designed to help patients avoid unnecessary acute care services by providing tailored nutritional support.Kaiser Permanente Southern California began offering MTM and nutritional counseling to Medi-Cal members who were at risk for malnutrition in mid-2022.Objective: To evaluate the implementation and outcomes of the MTM program, focusing on equitable outreach and patient satisfaction.Methods: Patients at risk for malnutrition (Malnutrition Screen Tool score of 3+) were either referred or proactively identified from the EMR and outreached for the program from Q2 2022 to Q4 2023.Participants who enrolled received two meals per day for 12 weeks, 2-4 dietitian consultations depending on the severity of malnutrition risk, and oral supplements as needed.English and Spanish-speaking patients were invited to complete either a web or phone satisfaction survey about the program.We used descriptive statistics to summarize the uptake and satisfaction results and conducted thematic content analysis of the open-ended satisfaction survey responses.Results: Of the eligible patients, outreach was equitable across socio-demographic subgroups.Of the 672 patients who enrolled in MTM, 50% completed the 12-week program.Non-completers had higher 90-day mortality rates and worse health at baseline.60% of 166 patients completed the satisfaction survey; patients reported moderate satisfaction with MTM with room for improvement in taste, quality and cultural variety of the meals.High satisfaction was driven by perceived convenience of the home-delivered meals and subjective health improvements, such as weight gain and reduced fatigue. Conclusion:The MTM program shows promise in improving health outcomes and satisfaction among Medi-Cal patients.However, enhancements in meal quality and variety and better targeting of patients could further improve program effectiveness.