Preliminary Data Analyses and Results

Below are some of the results from preliminary analyses of the data that were conducted and reported to each site during the summer of calendar year 2000.

Study Site A: Preliminary Outcome, Service & Cost Profile for Adults with Serious Problems With Drugs/Alcohol, Mental Health & Daily Living (Note: As Site A was just beginning to implement its pilot-test, these data represented the pre-pilot baseline data).

• Slightly over 400 outcome ratings were completed for members of this cluster over the course of five rating periods beginning in February 1995 and ending in February 1999. The ethnic make-up of the group is about 2/3 Caucasian, ¼ African American and 1/10 Hispanic. About 2/3 of the 400 ratings relate to males; the remaining 1/3 deal with female cluster members. However, data indicate that in recent years, the ratio of males to females in this cluster is approaching one-to-one.

• This is a high cost cluster! Data from FY 1999 indicate that the average cost of care was higher for this cluster than for any other at Site A. High hospital costs account for a large part of this. In fact, hospital costs represent nearly one-half of the estimated one million dollars that was spent on 118 members of this cluster in FY 1999. Further, during the 1-year period between February 1998 and February 1999, over ½ of the members of this cluster for whom outcome ratings were available were hospitalized at least once. The average hospital cost for these 62 people approached $9,400.00/year.

• Agency-wide snapshots of functioning of cluster members taken at each rating period indicate that during that time period they were functioning "moderately well" to "well" on many targeted treatment goals. These included their ability to complete basic living skills, get their regular health needs addressed, and to avoid getting into trouble with the criminal justice system. Their psychiatric symptoms continued to interfere in their lives at a moderate level, however they were beginning to overcome their denial of their addiction. They were consistently getting the public benefits to which they were entitled. On the other hand, they continued to have problems developing social connections to the drug-free community. Overall, even though changes were seen in performance on some outcomes between some rating periods, no pattern of improvement or decline was evident.

• Some gender and ethnic differences also were observed within this cluster. Hispanics were found to be doing better than African Americans and Caucasians on two outcomes (interference from psychiatric symptoms and being connected to a drug free community). Females were doing significantly better than males on six outcomes (e.g., overcoming denial, connecting to a drug free community, maintaining health).

• Community support program staff felt many more members of this cluster could be working (n = 273) than were presently working (n = 80). Overcoming denial appeared to be a key factor considered by staff in discriminating between cluster members who could and who could not work. Also, people who were presently working looked very similar on many outcomes to those who "could be working".

• Finally, data support the notion that overcoming denial is a particularly important outcome for members of this cluster. Overcoming denial was significantly related to four other outcomes. It was most strongly linked to attending substance abuse treatment in the community, followed by controlling addictive behavior, maintaining one's health, and avoiding involvement with the criminal justice system. The direction of causality is unknown, however, regardless of which outcomes are "causes" and which outcomes are "effects," the findings suggest that these outcomes are linked in meaningful ways.

Study Site B: Preliminary Test Of The Goodness Of Fit Hypothesis For Adults Who Are Severely Disabled In Many Life Areas (SAM GROUPS ONLY)

• The analyses shown in Table 1 the on the next page are based on 86 consumers who were consistently judged "fit" and 40 consumers consistently judged "not fit" to receive SAM Group services. Remember that the SAM groups began at the beginning of FY2000. Sample sizes for comparison groups are quite small so findings should be interpreted cautiously (but with optimism!) at this point.

• Preliminary analyses provide some support for the goodness of fit hypothesis. Cluster members who were judged fit for SAM and who received SAM (n = about 10), were doing better in three out of 4 outcome domains as of the second half of FY 2000, than Cluster members who were judged 'fit" but who were not receiving SAM services (n = 40). The domains in which SAM participants were reported as doing better than those judged "fit" but, not getting SAM (based on an 11-point rating scale) were: community living (7.4 vs 6.5, p <. 05); independence (8.0, p < .05); and, involvement in treatment (7.8 vs 6.5, p < .05). This finding was supported by both parametric and non-parametric tests. No difference was found between these groups in the symptom management domain (6.9 vs 6.4).

• Finally, with regard to the outcome data gathered during the second half of FY 2000, members of both groups judged to be 'fit' for SAM (getting SAM/not getting SAM) were doing better in all four outcome domains than those judged "not fit". However, this is may be a function of a selection bias that assumes that people need to be functioning at a certain level in order to be seen as "fit" for SAM.


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