Determinants of frail elders' lengths of stay in meals on wheels.

Home-delivered meal programs such as Meals on Wheels are low-cost long-term care services that have potential for contributing to the delay of costly institutionalization and to the maintenance of self-sufficiency and quality of life among community-dwelling frail elders. In this study, reasons for elders' termination from a Meals on Wheels program and determinants of their lengths of stay in the program are analyzed. The findings show that the reasons for elders' termination are largely associated with their deteriorating health. But it was also found that a significantly higher proportion of African American elders than White elders discontinued their participation due to their dissatisfaction with the meals offered or their poor appetite. The Cox proportional hazard regression analysis also confirmed that elders' health status, race, and appetite are significantly associated with the hazard of elders' termination. Strategies to improve the acceptability of the services are discussed.