Gary Morse, Ph.D. Mary York, LMSW Nathan Dell, AM, LMSW

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Presentation transcript:

Places for People: Initial Outcome Results for People Served After One Year Gary Morse, Ph.D. Mary York, LMSW Nathan Dell, AM, LMSW December 12, 2016 Analyses based on outcomes data collected between 1/2014 and 1/2016 for 327 people served

OVERALL AGENCY FINDINGS

Race

Gender

Clients by Program Type

Housing

Primary Care Doctor P = .059

Emergency Room – Any Reason

Reasons for Emergency Room Visit * * P = .052

Hospitalization – Any Reason

PHQ9 – Depression

No Significant Change Other housing categories School/job training Employment Overall health Current smoker Alcohol use* Drug use* Stage of treatment for substance abuse* Arrests, convictions, jail *Significant improvements were found between baseline assessment and 6 month, but not between baseline and 1 year

Major Conclusions and Implications Caveats: Most are not “true baselines” Small sample sizes for a few programs Positive changes in some areas, including: Decreased overall use of ER Decreased hospitalizations Both ER & hospital findings are positive for MCO contracts Decreasing levels of depression

Areas needing greater attention? -SA use overall and ER use for SA K2 factor? Need for more IDDT (now underway) Overall health (PBHCI underway) Employment Smoking cessation

HIGHLIGHTS OF OUTCOMES BY PROGRAM TYPES

Gender

Age

Race

Homeless Status OAT/Action saw significant decrease in homeless status at 12 months 32% homeless at baseline to 5% at 12 months (p=.021)

Health Increased enrollment into PCP services in the Oat/Action program (61% to 81%, p=.039) Increase in positive self-assessment of health status for Hope team clients (median “fair” to “good”, p=.022) Hospitalizations for any reason decreased significantly for OAT/Action (58% to 17%, p<.0005) and Residential clients (55% to 0%, p=.031)

Health (cont.) Significant decrease in ER visits for any reason for OAT/Action clients (53% to 22%, p=.019) Significant increase in ER visits due to substance use in ACT (6.8% to 16.3%, p=.006) Significant decrease in ER visits due to physical health for ACT clients (19% to 5%, p=.012), with positive trends for CPRP clients (p=.063)

Substance Use Persons in ACT, who had alcohol abuse or dependence at baseline, reduced the severity of alcohol use at 12 months 27% no longer indicated either alcohol use or dependence (p=.027)

Depression (PHQ-9 Scores) Baseline 12 Months Mean (SD) Sig. ACT 10.48 (7.31) 9.08 (6.58) .106 CPRP 9.93 (6.5) 6.96 (5.12) .001 Hope 10.0 (6.78) 7.12 (6.41) .087 Oat.Action 12.35 (7.78) 10.31 (5.32) .081 Residential 14.00 (5.59) 10.81 (6.16) .181 Path 8.46 (4.99) 6.09 (6.14) .151 3700 7.83 (5.69) 7.14 (4.45) .940

Summary and Major Conclusions by Program Type Some demographic differences between programs (e.g., CPRC serving somewhat older and lower rate of African-Americans, OAT/ACTION somewhat younger and higher rates of African-Americans)

Summary and Major Conclusions by Program Type (Continued) Some differences in rates of progress: OAT/ACT strongest positive change in reducing homelessness obtaining primary care reducing overall ER and hospital use Notes: OAT/ACTION more likely to reflect “true baseline” data and for persons to be in acute/worse states at program entry HOPE: strongest improvement in overall health ACT Strongest decrease in ER for physical reasons Greatest increase in ER use for SA (K2 factor?) Strongest decrease for SA from clinical ranges (abuse/dependence) CPRP Strongest reduction in level of depression (thou lower level at baseline)

HIGHLIGHTS OF ANALYSIS BY RACE

Homeless Status & Depression African Americans saw positive decreases in homeless status (9.5% to 5.6%, p=.064) PHQ-9 scores decreased for both races analyzed: Base 12 Months Mean (SD) Sig. African American 10.23 (6.90) 8.53 (6.12) .001 Caucasian 10.72 (7.18) 8.66 (6.38) .023

ER & Hospital Use African Americans reduced ER visits for any reason (35% to 25%, p=.008) African Americans reduced ER visits for mental health concerns (21% to 10%, p=.057) African Americans saw significant decrease in hospitalizations (28% to 14%, p<.0005) Caucasians also decreased hospitalizations, but this was not statistically significant (28% to 15%, p=.064)

Summary and Conclusions by Race Especially strong positive gains for African-Americans in terms of: Reducing homelessness Overall use of ER ER use for MH problems Hospitalizations (also a trend for Caucasians) Depression (also significant for Caucasians)