AMBULATORY VERSUS INPATIENT CARE IN FRANCE : ECONOMIC IMPACT OF PCI WITH STENTING
Author(s)
Pierre Loge1, Marilynne LIMA, Master2, Davide CILIBERTO, Master3, Isabelle Durand-Zaleski, MPP, PhD, MD4, Aline Topouchian, PhD3.
1Market Access manager, Terumo France SAS, Rueil Malmaison, France, 2Terumo Interventional Systems, Leuven, France, 3Terumo Interventional Systems, Leuven, Belgium, 4Assistance Publique Hopitaux de Paris URCEco, Paris, France.
1Market Access manager, Terumo France SAS, Rueil Malmaison, France, 2Terumo Interventional Systems, Leuven, France, 3Terumo Interventional Systems, Leuven, Belgium, 4Assistance Publique Hopitaux de Paris URCEco, Paris, France.
OBJECTIVES: In France, the development of ambulatory care (AC) has become a major priority for the healthcare system, aiming to improve efficiency, optimize resource use, and enhance patient experience. This shift has been supported by public health policies and financial incentives. The objective of this study was to compare expenditures associated with coronary angioplasty with stenting between AC and inpatient stays.
METHODS: Epidemiological data were extracted from the French PMSI databases (2025). Relevant medical procedures (CCAM codes) for coronary angioplasty with stenting and associated diagnosis-related groups (DRGs) were identified using publicly available data. Patients eligible for AC were defined as those classified in DRGs with no significant comorbidities (maximum severity level 1) and without myocardial infarction. Direct costs were estimated using the National Cost Study methodology (ENCC - 2023). It was assumed that procedures were comparable between AC patients and eligible patients treated through inpatient stays. The perspective adopted was public hospitals, with a time horizon limited to the initial stay.
RESULTS: A total of 200,465 coronary angioplasty procedures with stenting were performed in France. The main DRG was 05K06 (“coronary dilatation without infarction”). Based on ENCC data, average costs were estimated at €1,754 for AC versus €2,512 for inpatient stays, corresponding to €758 (30%) decrease per stay. Most decreases were driven by reduced clinical, intensive care, and resuscitation resource use (€480), along with lower direct charges (€210). At a national level, increasing AC utilization would result in a reduction of €18,7 million in public hospitals, assuming a total conversion of all eligible patients to ambulatory care.
CONCLUSIONS: This analysis highlights the potential for substantial cost reduction through AC compared with inpatient care in France. According to ENCC estimates, AC may reduce costs by up to 30%, primarily through decreased overnight stay, while supporting efficiency gains.
METHODS: Epidemiological data were extracted from the French PMSI databases (2025). Relevant medical procedures (CCAM codes) for coronary angioplasty with stenting and associated diagnosis-related groups (DRGs) were identified using publicly available data. Patients eligible for AC were defined as those classified in DRGs with no significant comorbidities (maximum severity level 1) and without myocardial infarction. Direct costs were estimated using the National Cost Study methodology (ENCC - 2023). It was assumed that procedures were comparable between AC patients and eligible patients treated through inpatient stays. The perspective adopted was public hospitals, with a time horizon limited to the initial stay.
RESULTS: A total of 200,465 coronary angioplasty procedures with stenting were performed in France. The main DRG was 05K06 (“coronary dilatation without infarction”). Based on ENCC data, average costs were estimated at €1,754 for AC versus €2,512 for inpatient stays, corresponding to €758 (30%) decrease per stay. Most decreases were driven by reduced clinical, intensive care, and resuscitation resource use (€480), along with lower direct charges (€210). At a national level, increasing AC utilization would result in a reduction of €18,7 million in public hospitals, assuming a total conversion of all eligible patients to ambulatory care.
CONCLUSIONS: This analysis highlights the potential for substantial cost reduction through AC compared with inpatient care in France. According to ENCC estimates, AC may reduce costs by up to 30%, primarily through decreased overnight stay, while supporting efficiency gains.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE470
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas