2014 Project Access Health Outcomes

In 2014, Project Access patients who exited Project Access and who participated in
both a pre- and post-survey by telephone, showed a marked improvement in selfreported health status. An internally developed health outcomes survey was used.
Analysis indicated both statistically significant and clinically substantive results. It
should be noted this year that the overall population mean showed markedly better
perceived health at entry into Project Access as compared to 2013 (11.56 pre-test mean
in 2014; 13.90 pre-test mean in 2013). Note that lower scores indicate better selfreported health.
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 2014 Project
Access benchmark for the health outcome survey is a 10% improvement (i.e., reduction
or negative difference) in total population mean scores for all patients responding. An
additional benchmark is a 25% improvement in mean scores for at least 60% of patients
Health outcomes surveys were conducted by telephone with Project Access patients on
a voluntary basis. Post-test surveys were administered to patients who exited 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 228 patients who completed a pre-test in 2011,
2012 or 2013 and a post-test in 2014. Difference scores were calculated by subtracting
the post-test score from the pre-test score. Pre- and post-test scores were analyzed
using a paired t-test to compare means.
Overall population results
A comparison of means showed an improvement of 1.20 points (actually -1.20, which
indicates improved reported health status) for the total population at post-test. Analysis
indicates that the results are statistically significant (p<.001). A total population mean
reduction of 1.20 is smaller than the 2.00 mean improvement reported in 2013. This
may be due to respondents reporting much better perceived initial health (i.e., not as
much room for improvement) this year. (See Conclusion above.)
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March 2015
As compared to the total population mean pre-test score of 11.56, the mean post-test
score is reduced to 10.36. A reduction of 1.20 points is a 10.4% improvement in the
mean population scores (11.56-10.36 = -1.20/11.56 = 10.4%). As noted above, a
10% reduction is the total population benchmark for the 2013 Project Access health
outcome measure.
An improvement of 10 points for the overall population may be considered clinically
substantive, given that a number of Project Access patients have degenerative or
chronic conditions, where physical and emotional health status may remain the same or
decline even with access to high-quality treatment.
Patients reporting improved health
136 out of 228 patients (60%) reported improved health status at post-test, with
improved scores ranging from -1 to -10 points. As compared to the total 2014
population, this sub-group of patients had higher (worse) average pre-test scores
(12.26), but a larger average improvement (-3.18) at post-test with a mean of 9.13. This
represents a 26% (3.18/12.26) improvement for this sub-group only.
The 2014 sub-group also had a markedly better pre-test mean score (12.26) as
compared to the “improved” sub-group from 2013 (14.95).
Social/emotional functioning
The health outcomes survey has one item that inquires about limitations of daily
functioning due to emotional or mental health. This is a question with three possible
responses, with a score of “1” representing “not” limited functioning and “5” representing
“very limited” functioning.
At pre-test, 62% (142/228) of respondents reported that they had limited or very limited
functioning due to emotional or mental health. 38% (86/142) reported no limitations due
to emotional or mental health at pre-test.
At post-test, 62% (141/228) of respondents had unchanged functioning, while 27%
(62/228) had improved functioning and 11% (25/228) had decreased functioning. The
mean score on this item improved by 14% from 2.53 to 2.18 (roughly halfway between
“not limited” and “somewhat limited”). The change in mean scores is significant at
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March 2015
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