{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:44:28Z","timestamp":1791931468827,"version":"4.3.4"},"reference-count":4,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,6,3]],"date-time":"2013-06-03T00:00:00Z","timestamp":1370217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:p>Chronically ill populations have a strong need for quality public health nutrition services to aid in disease management and improve health outcomes. Evidence suggests that neglecting the importance of adequate nutrition in chronically ill patients has far-reaching implications on the health status of the individual and the health care costs. Research is currently lacking a focus on this topic. This pilot study done through the nonprofit organization MANNA (Metropolitan Area Neighborhood Nutrition Alliance), which serves the greater Philadelphia area, explored the health care expenditures of 65 MANNA clients over time in comparison with a similar group of Medicaid patients who did not receive MANNA services. Health care expenditures were examined before and after clients began receiving services. The study found that the mean monthly health care costs decreased for three consecutive months after initiation of MANNA services. Other health care cost\u2013related factors, such as inpatient costs, length of stay, and number of hospital admissions also displayed a downward trend. These results help show the significance of medical nutrition therapy and home-delivered meal services on overall health care.<\/jats:p>","DOI":"10.1177\/2150131913490737","type":"journal-article","created":{"date-parts":[[2013,6,3]],"date-time":"2013-06-03T21:27:39Z","timestamp":1370294859000},"page":"311-317","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":49,"title":["Examining Health Care Costs Among MANNA Clients and a Comparison Group"],"prefix":"10.1177","volume":"4","author":[{"given":"Jill","family":"Gurvey","sequence":"first","affiliation":[{"name":"OMG Center for Collaborative Learning, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Rand","sequence":"additional","affiliation":[{"name":"MANNA (Metropolitan Area Neighborhood Nutrition Alliance), Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Daugherty","sequence":"additional","affiliation":[{"name":"MANNA (Metropolitan Area Neighborhood Nutrition Alliance), Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyndi","family":"Dinger","sequence":"additional","affiliation":[{"name":"MANNA (Metropolitan Area Neighborhood Nutrition Alliance), Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Schmeling","sequence":"additional","affiliation":[{"name":"Drexel University School of Public Health, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Laverty","sequence":"additional","affiliation":[{"name":"MANNA (Metropolitan Area Neighborhood Nutrition Alliance), Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,6,3]]},"reference":[{"key":"bibr1-2150131913490737","doi-asserted-by":"publisher","DOI":"10.1177\/108482239100300205"},{"key":"bibr2-2150131913490737","first-page":"61","volume":"8","author":"Gamble J","year":"2008","journal-title":"Ochsner J"},{"key":"bibr3-2150131913490737","unstructured":"DeVol R, Bedroussian A. An Unhealthy America: The Economic Burden of Chronic Disease. Santa Monica, CA: The Milken Institute; 2007:1-38."},{"key":"bibr4-2150131913490737","unstructured":"US Department of Health and Human Services. 2013 Poverty guidelines. Office of the Assistant Secretary for Planning and Evaluation. http:\/\/aspe.hhs.gov\/poverty\/index.shtml. Accessed February 5, 2013."}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2150131913490737","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2150131913490737","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2150131913490737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:24:25Z","timestamp":1777508665000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2150131913490737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,3]]},"references-count":4,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1177\/2150131913490737"],"URL":"https:\/\/doi.org\/10.1177\/2150131913490737","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,3]]}}}