Journal of Novel Physiotherapies
Open Access

Soft tissue injuries; Pediatric patients; Physiotherapy-led clinic; Healthcare resource utilization

Introduction

Soft tissue injuries are a prevalent health issue among pediatric patients, often leading to visits to emergency departments (EDs) or primary care physicians (PCPs). These injuries encompass a wide range of musculoskeletal conditions, including strains, sprains, contusions, and minor fractures, and can result from various activities, such as sports, recreational play, and accidents. While these injuries are typically non-life-threatening, they contribute significantly to healthcare resource utilization and costs. The traditional approach to managing pediatric soft tissue injuries involves ED visits or PCP consultations, which can lead to prolonged wait times and increased healthcare expenditures [1]. Moreover, these settings may not always be equipped with the specialized knowledge and resources necessary to provide optimal care for such injuries. As a result, there is a growing interest in alternative models of care that streamline the assessment, diagnosis, and treatment of soft tissue injuries in pediatric populations. One such model is the Soft Tissue Injury Clinic (STIC) led by physiotherapists. The STIC model aims to provide specialized care for soft tissue injuries, optimizing resource utilization, reducing wait times, and improving patient satisfaction. While studies have shown the effectiveness of physiotherapy-led STICs in the management of musculoskeletal conditions in adults, limited research has focused on their application in the pediatric population. This study seeks to address this gap by evaluating the efficiency and cost-effectiveness of a pediatric-specific STIC through an interrupted time series analysis.

Methods

Study design

This research employed an interrupted time series study design, a robust quasi-experimental design commonly used in healthcare research to assess the impact of interventions over time. Data were collected over a 24-month period, comprising 12 months before the implementation of the pediatric-specific STIC and 12 months after its establishment.

Participants

The study included all pediatric patients (aged 18 years and under) with soft tissue injuries who sought medical care within the healthcare system during the study period. Patients were identified through medical records and administrative data.

Intervention

The intervention consisted of the introduction of a pediatricspecific Soft Tissue Injury Clinic, led by experienced physiotherapists.

The clinic was designed to offer specialized assessment, diagnosis, and treatment for pediatric soft tissue injuries, including strains, sprains, contusions, and minor fractures [2].

Outcome measures

Healthcare resource utilization: The primary outcome measure was the change in healthcare resource utilization for pediatric soft tissue injury management. This was assessed by comparing the number of ED visits and PCP consultations before and after STIC implementation.

Wait times: The study measured changes in wait times for assessment and treatment of soft tissue injuries in pediatric patients.

Wait times were defined as the time from initial contact with the healthcare system to the initiation of treatment.

Patient satisfaction: Patient satisfaction was assessed using validated survey instruments. Participants were asked to rate their satisfaction with the care received in the STIC compared to their previous experiences with ED or PCP care [3].

Cost-effectiveness: A cost-effectiveness analysis was conducted to determine the economic impact of the STIC model. Costs included direct healthcare costs associated with ED and PCP visits, physiotherapy services, and administrative expenses.

Data analysis

Statistical analyses were performed to compare pre- and post-STIC implementation data. Descriptive statistics, including means, standard deviations, and percentages, were calculated for relevant variables [4-7]. Bivariate analyses were conducted using chi-square tests for categorical variables and t-tests for continuous variables. Interrupted time series analyses were used to assess trends and changes in healthcare resource utilization and wait times. Cost-effectiveness was evaluated by comparing the total healthcare costs before and after STIC implementation. Ethical approval was obtained from the institutional review board (IRB) before data collection.

Results

Demographics

A total of 342 pediatric soft tissue injury cases were included in the study. The mean age of the participants was 11.2 years, with a nearly equal gender distribution. The majority of injuries were sports-related (64%), followed by recreational accidents (22%) and minor falls (14%).

Healthcare resource utilization

Following the implementation of the pediatric-specific STIC, there was a significant reduction in the number of ED visits (p < 0.001) and PCP consultations (p = 0.003). Specifically, ED visits for soft tissue injuries decreased by 42%, and PCP consultations decreased by 36%.

Wait times

Wait times for assessment and treatment of soft tissue injuries were substantially reduced post-STIC implementation. The average wait time decreased by 35%, resulting in a more efficient and timely provision of care.

Patient satisfaction

Patient satisfaction scores improved significantly after the introduction of the STIC (p < 0.001). Participants reported higher levels of satisfaction with the specialized care provided by physiotherapists compared to previous experiences with ED or PCP care.

Cost-effectiveness

The cost-effectiveness analysis demonstrated a notable reduction in healthcare costs associated with pediatric soft tissue injury management after the introduction of the STIC. The reduction in ED visits and PCP consultations resulted in cost savings that offset the expenses associated with establishing and operating the clinic.

Discussion

The findings of this interrupted time series study provide strong evidence that a physiotherapy-led Soft Tissue Injury Clinic is an efficient. The implementation of a physiotherapy-led Soft Tissue Injury Clinic (STIC) tailored for pediatric patients has demonstrated remarkable efficiency and cost-effectiveness in the management of soft tissue injuries. This study's findings underscore the transformative potential of this specialized care model within the pediatric healthcare landscape. The primary outcomes of this study reveal substantial benefits associated with the STIC model. Notably, there was a significant reduction in healthcare resource utilization, with a substantial decrease in both emergency department (ED) visits and primary care physician (PCP) consultations [8-10]. This reduction translates into a more efficient allocation of healthcare resources and a decreased burden on these traditional healthcare settings. Wait times for assessment and treatment also showed significant improvement, leading to more timely care provision. Reduced wait times not only enhance patient satisfaction but also contribute to the prevention of secondary complications and expedited recovery.

Conclusion

Patient satisfaction scores demonstrated a significant increase after the introduction of the STIC. Pediatric patients and their families expressed greater contentment with the specialized care provided by physiotherapists within the STIC, highlighting the importance of patient-centered care models. The physiotherapy-led STIC represents a promising and efficient paradigm shift in the management of pediatric soft tissue injuries. Perhaps most notably, the cost-effectiveness analysis revealed that the cost savings resulting from reduced ED visits and PCP consultations offset the expenses associated with establishing and operating the STIC. This economic advantage, combined with improved patient outcomes and experiences, positions the physiotherapy-led STIC as an attractive model of care. It not only streamlines healthcare resource utilization but also enhances the quality of care and patient satisfaction while remaining cost-effective. The findings of this study advocate for the wider adoption of specialized clinics led by physiotherapists to optimize the care pathway for soft tissue injuries, ultimately benefiting both patients and healthcare systems. Further research and replication of this model in diverse healthcare settings are warranted to confirm its broader applicability and impact. The physiotherapy-led STIC stands as an exemplar of how innovative healthcare delivery can lead to more efficient, patient-centric, and costeffective care models.

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