Housing and Support Program (HASP): Final Evaluation Report

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Section 6
The ability of the program to maintain clinical functioning and provide
an acceptable quality of life for those supported by the program
This section of the report explores factors related to clinical functioning and how these
are maintained under HASP. Factors such as changes in clinical functioning, medication use,
physical health, client goals, participation in meaningful activities, employment, level of
independence and the need for inpatient care are discussed.
6.1 Readmissions to acute
inpatient care
The need for readmission to acute care is one indicator
of how well a program can maintain clinical functioning
in individuals with high levels of disability. Of the
80 clients in our sample, admission data (number
of admissions and length of stay) were available for
70 clients at 12 months prior to entering HASP and
12 months post-entry into HASP. While 61 of the
70 clients for which data were available (87.1%)
required time in hospital in the 12 months prior to
HASP, 41 of these clients spent the entire 12 months
in hospital prior to entry into HASP. However, following
entry into HASP, only 26 clients (37.1%) required time
in hospital in the 12 months post-HASP.
The average time in inpatient care for each individual
in the 12 months prior to HASP decreased signifi cantly
from an average of 227 days to an average of
18.9 days in the 12 months post-HASP. This reduction
in inpatient bed days was statistically signifi cant
(paired t = 10.44, p=0.001). Finally, the number of
admissions also decreased signifi cantly from an
average of 1.22 admissions in the 12 months prior to
HASP, to an average of .66 admissions per individual
in the 12 months post-HASP (paired t = 3.22,
p=0.002).
Final Evaluation Report
6.2 Changes in functioning
As noted earlier, ‘outcomes’ data were obtained from
the Queensland Health Information System ‘CIMHA’
for the 77 clients who provided written consent for
their data to be used for the evaluation. (Three clients
refused to provide consent for their outcomes data
to be used in this way). Having identifi ed the date
that each individual entered HASP, it was possible to
obtain the outcomes data from CIMHA for clients at 12
months and three months prior to entering HASP and
for three months and 12 months after entering HASP.
The mean scores for the both the Life Skills Profi le
(LSP) and the Health of the Nation Outcome Scales
(HoNOS) are summarised in the graph below. The LSP
provides a measure of general life skills functioning,
while the HoNOS provides an assessment of disability
and clinical functioning. There was a considerable
amount of missing data for the 77 clients. HoNOS data
were available for 33 of the 77 clients across all four
time-points, while LSP data were available for 17 of the
77 clients across all four time-points.
Fig. 6.1 Changes in functioning
Score
20
15
10
5
0
Legend
HoNOS (n=33)
12
months
pre
3
months
pre
LSP (n=17)
3
months
post
12
months
post
Overall, the clients, as a group, demonstrated
improvement in functioning as indicated by the lower
mean scores (lower scores on these scales indicate