OBJECTIVES : Transient ischemic attack (TIA) is an excellent opportunity to prevent stroke. Thus, urgent management of TIA in a specialized center is associated with a reduction from 50 to 80% of recurrence risk. The aim of this study was to determine the hospital costs saving impact of an outpatient TIA Clinic located at Toulouse University Hospital (TUH) in south of France.

METHODS : This study was conducted from the French Healthcare insurance perspective. This is a retrospective analysis from the diagnosis related group (DRG) data base before (Phase I) and after (Phase II) the opening of an outpatient TIA Clinic Unit in TUH. All patients with TIA who were admitted in 2008 (Phase I) or in 2015 (Phase II) in TUH Neurovascular unit were included. Unit costs for DRG were based on reference prices from the French Healthcare insurance boards and tariffs.

RESULTS :

549 hospital stays were analyzed in 2008 and 535 in 2015. Outpatient management (hospitalization duration<24hours) increased in phase II as compared to phase I (34%, n=180) vs 12%, n=68) (P<0,005) and was associated with a reduction of 1,64 days of lenght of stay per patient.Total costs for TIA care, whether in outpatient or patient facilities, decreased from1 511 186€ (2 223 107$) (phase I) to 896 767€ (989 223$) (phase II) corresponding to a 614 419€ (1 233 884$) saving as total and 1 148€ (2306$) saving per patient.Average costs per stay decreased from 2 753€ (3 276$) in Phase I to 1 676€ (1 973$) in phase II.

CONCLUSIONS : This first study in french context corroborates English and Dutch studies and shows that TIA Clinic model is associated with a cost reduction, which is of particular interest in the current context of expanding health expenses.