title: Utilization and cost of a new model of care for managing acute knee injuries: the Calgary Acute Knee Injury Clinic.
abstract: BACKGROUND
  Musculoskeletal disorders (MSDs) affect a large proportion of the Canadian population and present a huge problem that continues to strain primary healthcare resources. Currently, the Canadian healthcare system depicts a clinical care pathway for MSDs that is inefficient and ineffective. Therefore, a new inter-disciplinary team-based model of care for managing acute knee injuries was developed in Calgary, Alberta, Canada: the Calgary Acute Knee Injury Clinic (C-AKIC). The goal of this paper is to evaluate and report on the appropriateness, efficiency, and effectiveness of the C-AKIC through healthcare utilization and costs associated with acute knee injuries.
  
  
  METHODS
  This quasi-experimental study measured and evaluated cost and utilization associated with specific healthcare services for patients presenting with acute knee injuries. The goal was to compare patients receiving care from two clinical care pathways: the existing pathway (i.e. comparison group) and a new model, the C-AKIC (i.e. experimental group). This was accomplished through the use of a Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ).
  
  
  RESULTS
  Data from 138 questionnaires were analyzed in the experimental group and 136 in the comparison group. A post-hoc analysis determined that both groups were statistically similar in socio-demographic characteristics. With respect to utilization, patients receiving care through the C-AKIC used significantly less resources. Overall, patients receiving care through the C-AKIC incurred 37% of the cost of patients with knee injuries in the comparison group and significantly incurred less costs when compared to the comparison group. The total aggregate average cost for the C-AKIC group was $2,549.59 compared to $6,954.33 for the comparison group (p <.001).
  
  
  CONCLUSIONS
  The Calgary Acute Knee Injury Clinic was able to manage and treat knee injured patients for less cost than the existing state of healthcare delivery. The combined results from this study show that the C-AKIC is an appropriate, effective, and efficient model of clinical care for patients presenting with acute knee injuries.
authors.affiliation: Department of Physical Education and Recreational Studies, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB T3E 6K6, Canada. blau@mtroyal.ca
authors.forename: Breda H F
authors.initials: BH
authors.lastname: Lau
authors.forename: Mark R
authors.initials: MR
authors.lastname: Lafave
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Mohtadi
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Butterwick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta; D002648:Child; D016001:Confidence Intervals; D019091:Critical Pathways; D004632:Emergency Medical Services / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007718:Knee Injuries / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult