Quality of Life and Health Knowledge Item 51: Results from HRSA/HAB's SPNS Innovative Models of Care

Knowledge Item: CA-Quality of Life and Health-51
Trends in Quality of Life Over the Course of the Treatment Episode Part XIV–Maximum Degree of Improved Quality of Life as a Function of Treatment in Different Types of Programs

This Knowledge Item is a direct follow-up to Knowledge Item: CA-Quality of Life and Health-42, Knowledge Item: CA-Quality of Life and Health-43, and Knowledge Item: CA-Quality of Life and Health-50.

The maximum change in quality of life over the course of the treatment episode was estimated and is related to a number of factors, including most importantly the relative ability of three kinds of services–managed medical care; comprehensive medical care including "wrap-around" social services; community-based psychosocial service providers–to improve the overall quality of life of their patients. The Comprehensive Medical Care and Psychosocial Service providers had patients who obtained the greatest increase in quality of life over the treatment episode. These results statistically control for the initial baseline level of quality of life, differences due to psychosocial and behavioral comorbidities, and other patient characteristics. The related Knowledge Items CA-Medical-Outcomes-11, -12, -13, and -14, control for the level of medical functioning near enrollment as well and also examine the relationship of these results to AIDS-defining conditions.

On average, the patients in the Community Based Organization projects had an increase of 31% in quality of life, while the patients in the University-based Comprehensive Healthcare projects had an average increase of 30%, and the patients in the Managed Care projects had an increase of 6%. Minor variations in these estimates are shown in the Additional Statistics section of this Knowledge Item; the different estimates are based on controlling different factors including patient demographics, time in program, time between assessments, initial quality of life level, and other behaviors and vulnerabilities.

Mean Ratio of Highest Quality of Life Score to Baseline Over the Course of Treatment (Ratio > 100 is Improvement) Over the Course of Treatment

Percentage of Patients Who Have Improved Quality of Life Above Baseline Over the Course of Treatment

More Information: CHAID and CHAID Diagram

Note: The sample size for this Knowledge Item is 38 patients smaller than that of Knowledge Item CA-Quality of Life and Health-43 to which this is a follow-up. We did not use the data from one Managed Care medical site in this analysis specifically because the goal of the project was to treat people at the end of their lives when quality of life is low. All other projects, including those whose data are used here, are primarily providers of outpatient medical care, rather than home health care.

In interpreting this Knowledge Item, and all others in this section on Quality of Life and Health, remember that the ratings of quality of life, symptom impact, and healthcare utilization are based on patient self reports.

Knowledge Item Citation: Huba, G. J., Melchior, L. A., Panter, A. T., and the HRSA/HAB SPNS Cooperative Agreement Steering Committee (1998-2001). Knowledge Item: CA-Quality of Life and Health-51 from HRSA/HAB's SPNS Cooperative Agreements on Innovative Models of Care, The Measurement Group Knowledge Base on HIV/AIDS Care, Online at www.TheMeasurementGroup.com.

Last Updated: March 25, 2005; data through June 15, 1999; analyses conducted March - June 2000.

Knowledge Base Citation: The Knowledge Base and this Knowledge Item were designed and authored by G. J. Huba, Ph.D.; in collaboration with Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; and the staff of The Measurement Group. Cite this work as "Huba, G. J., Melchior, L. A., and Panter, A. T. (1998 - 2001). The Measurement Group Knowledge Base on HIV/AIDS Care. On the World Wide Web: http://www.TheMeasurementGroup.com."

Questions or Comments: Contact The Measurement Group.

Use of Knowledge Base Information: Acceptable Uses and Limitations.

Collaborators from Participating Projects: Cooperative Agreement Steering Committee 1999.

Participating Projects: This Knowledge Base is based on the service delivery experiences of 27 Cooperative Agreement Projects on Innovative Models of HIV/AIDS Care. These projects and the Evaluation and Dissemination Center which produced this Knowledge Base were funded by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) as Special Projects of National Significance (SPNS) between 1994 and 1999. Click the Model Programs button above for descriptions of the projects that contributed to this specific Knowledge Item, a list of key staff, and project grant numbers.

Why This Evaluation was Conducted: Editorial.

More Information: Design of this Knowledge Base.

Recommended Citation Format for Web Materials: American Psychological Association Publication Manual Section, Revised 2001.

Work on the Knowledge Base and the cross-cutting evaluation was supported in part by Grant Number 5 U90 HA 00030-05 from the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's (HAB) Special Projects of National Significance (SPNS). The contents of this Knowledge Base are solely the responsibility of The Measurement Group and do not necessarily represent the official views of HRSA or HRSA/HAB's Special Projects of National Significance nor may they represent the positions of the individual grantees whose projects are included in the cross-cutting evaluation.