AUTHOR=Choe Hwi , Pak Tae-Young 

TITLE=Food Insecurity, Healthcare Utilization, and Healthcare Expenditures: A Longitudinal Cohort Study

JOURNAL=International Journal of Public Health

VOLUME=68

YEAR=2023

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2023.1605360

DOI=10.3389/ijph.2023.1605360

ISSN=1661-8564

ABSTRACT=<p><bold>Objective:</bold> This study examines the longitudinal association between household food insecurity and healthcare utilization and expenditure.</p><p><bold>Methods:</bold> A multi-wave longitudinal cohort study was conducted using the 2008–2019 and 2021 waves of the Korean Welfare Panel Study. The baseline data included participants aged ≥19 years with valid responses to the food insecurity and healthcare questionnaires in the 2008 wave (<italic>n</italic> = 12,166). Healthcare outcomes encompassed outpatient visits, inpatient admissions, days hospitalized, and personal healthcare expenditure. Random effects Poisson and linear regressions were estimated.</p><p><bold>Results:</bold> Severe food insecurity was associated with a higher incidence rate of outpatient visits (IRR, 1.14; 95% CI, 1.12–1.17), days of hospitalization (IRR, 1.18; 95% CI, 1.13–1.22), and inpatient admissions (IRR, 1.40; 95% CI, 1.18–1.65). Moderate food insecurity was associated with 10.4% (<inline-formula id="inf1"><mml:math id="m1" xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mi>β</mml:mi></mml:mrow></mml:math></inline-formula> = −0.11; 95% CI, −0.14 to −0.07) or 238,276 KRW reductions in personal healthcare expenditures in the subsequent year.</p><p><bold>Conclusion:</bold> Household food insecurity was linked to increased healthcare utilization and reduced personal healthcare expenditure among Korean adults. Our findings present opportunities to identify target populations for healthcare policies and interventions.</p>