2012 PROJECT ACCESS HEALTH OUTCOMES SURVEY RESULTS
Conclusion
In 2012, Project Access patients who were disenrolled, and who participated in both a
pre- and post-survey by telephone, showed a marked improvement in self-reported
health status. An internally developed health outcomes survey was used. Analysis
indicated both statistically significant and clinically substantive results.
Notes
Scores for the survey instrument range from 5 (best possible self-reported health) to 25
(worst possible self-reported health). There is a range of 21 possible scores in this
survey. Negative difference scores represent improvement and positive difference
scores represent a deterioration of perceived health. The 2012 Project Access
benchmark for the health outcome surveys is a10% improvement (i.e., reduction or
negative difference) in total population mean scores.
Methodology
Health outcome surveys were conducted by telephone with Project Access patients on
a voluntary basis. Post-test surveys were administered to patients who were
disenrolled from Project Access and who had participated in a pre-test survey
conducted shortly after their enrollment in the program.
Paired scores were evaluated for all 305 patients who completed a pre-test in 2011 or
2012 and a post-test in 2012. Difference scores were calculated by subtracting the pretest score from the post-test score. Pre- and post-test scores were analyzed using a
paired t-test to compare means.
Results
A comparison of means showed an improvement of 2.14 points (actually -2.14, which
indicates improved reported health status) for the total population upon post-test. T-test
results indicate that the results are statistically significant (p<.001). A total population
mean reduction of 2.14 points may also be considered clinically substantive, given
that a number of Project Access patients have degenerative or chronic conditions,
where physical and emotional health status may decline or stay the same even with
access to high-quality treatment.
As compared to the total population mean pre-test score of 13.83, the mean post-test
score is reduced to 11.69. A reduction of 2.14 points is a 15.5% improvement in the
mean population scores (13.83 – 11.69 = 2.14/13.83 = 15.5%). As noted above, a
10% reduction is the benchmark for the 2012 Project Access health outcome measure.
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Rev. March 2013
190 out of 305 patients (62%) reported improved health status, with improved scores
ranging from -1 to -16 points. The mode (most frequent) pre-test score was 15, while
the most frequent post-test score was 6, which is quite close to the best possible score
of 5. See scatterplots on p. 3.
Employment status
Change in employment status was also measured. Patients were asked at pre- and
post-test whether they were employed and for how many hours. No benchmark for
these results was set in 2011.
Important note: Unemployed people may be more likely to take daytime telephone
surveys, so these results may be overrepresented by those who were unemployed at
the time of the survey.
Employment status - results
48% (146) of respondents were unemployed at both pre-test and post-test
23% (68) stayed employed with the same number of hours
11% (34) became employed
13% (39) stayed employed, but either gained or lost hours
27 gained hours, with 18 going from part- to full-time
12 lost hours, with 6 going from 40 hrs/week to 21-30 hrs/week
5% (16) became unemployed
Social/emotional functioning
The survey has one item that inquires about limitations of daily functioning due to
emotional or mental health. This is a 3-item question, with a score of “1” representing
the best outcome and “5” representing the worst outcome.
59% (193) of respondents had unchanged functioning at post-test, while 30% (93) had
improved functioning and 11% (33) had decreased functioning. The mean score
improved by 17% from 2.42 to 2.00 (halfway between “not limited” and “somewhat
limited”). The change is mean scores is significant at p<.001.
The median (or halfway point, with half the answers above and half the answers below)
changed from pre-test to post-test. The median score for the pre-test on this item is 3
(somewhat limited), while the median score for the post-test on this item is 1 (not limited
at all). See scatterplots on p. 4.
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SCATTERPLOTS
Total scores, items 1 – 5, pre-test (Note: 5 = best possible score; 25 = worst possible score)
30
25
20
15
Series1
10
5
0
0
200
400
600
800
Total scores, items 1 – 5, post-test (Note: 5 = best possible score; 25 = worst possible score)
30
25
20
15
Series1
10
5
0
0
100
200
300
400
500
600
700
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Rev. March 2013
SCATTERPLOTS
Scores for item 5 only, pre-test (Note: 1 = best possible score; 5 = worst possible score)
(Single item that measures daily functioning limitations due to emotional or mental health)
Pre-test
6
5
4
3
Pre-test
2
1
0
0
100
200
300
400
500
600
700
Scores for item 5 only, pre-test (Note: 1 = best possible score; 5 = worst possible score)
Post-test
6
5
4
3
Post-test
2
1
0
0
100
200
300
400
500
600
700
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Rev. March 2013