Knowledge Item: CA-Summary of Maximum Patient Outcomes-12
 Psychosocial and Medical Outcomes by Insurance Coverage: Maximum Change Estimates

Positive Outcomes: Maintained or Enhanced Functioning Over Time During Program
[Insurance Coverage]

Outcomes

Difference Due to Insurance Coverage

 Chi-Square
Quality of Life Yes c2(2) = 22.084, p =.000
Symptoms Yes c2(2) = 30.802, p =.000
Psychological Distress No c2(2) = 2.729, p =.256
Service Barriers No c2(2) = 2.159, p =.340
CD4 Count No c2(2) = 1.216, p =.545
Karnofsky Severity Rating No c2(2) = 4.952, p =.084
Viral Load No c2(2) = 5.625, p =.060

Notes:

  1. Psychosocial Projects did not collect medical indicators.

  2. The number of patients in each group varies by outcome and may be quite small in some cases.

  3. Symptom severity is considered to be a Psychosocial Outcome because the index of symptom severity is derived from patient self reports.

This Knowledge Item is a direct follow-up to a series of Knowledge Items that study the maximum degree of change patients (clients) experience during their treatment episodes. The following table shows the Knowledge Items to which this Knowledge Item is a follow-up.

Dependent Variable Knowledge Item
Quality of Life CA-Quality of Life and Health-42
Self-Perceived Symptom Severity CA-Quality of Life and Health-66
Psychological Distress CA-Psychological Distress-17
Self-Perceived Barriers to Services CA-Barriers and Facilitators-33
CD4 Counts CA-Medical Outcomes-17
Karnofsky Severity Rating CA-Medical Outcomes-21
Viral Load CA-Medical Outcomes-25

The maximum change results presented throughout this Knowledge Base permit an assessment of whether patients change over time on a variety of outcome measures where change is defined as the "best" possible score the patient achieves at any time during the treatment episode as compared to the baseline score. 

This Knowledge Item follows up on the prior results by examining whether groups of patients, disaggregated by their insurance coverage have greater than chance levels of improvement. On most major indicators of outcomes, patients with differing types of insurance had similar levels of positive outcomes, with the degree of positive outcomes significantly above chance levels. Note that this definition of program success means that a patient is either maintained at baseline level or that the scores have improved at some time during the entire course of the treatment episode. The parallel Knowledge Item: Summary of Patient Outcomes-12 uses an alternate definition of patient successful outcomes and suggests approximately the same result.

Positive Outcomes: Maintained or Enhanced Functioning Over Time During Program
[Insurance Coverage]

The following chart is another way of looking at the same data presented in the top figure.

Notes:

  1. Psychosocial Projects did not collect medical indicators.

  2. The number of patients in each group varies by outcome and may be quite small in some cases.

  3. Symptom severity is considered to be a Psychosocial Outcome because the index of symptom severity is derived from patient self reports.

Knowledge Item Citation: Huba, G. J., Panter, A. T., Melchior, L. A., and the HRSA/HAB SPNS Cooperative Agreement Steering Committee (1998-2001). Knowledge Item: CA-Summary of Maximum Patient Outcomes-12 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 August 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.

© Copyright 2005 by The Measurement Group LLC. All rights reserved.