Costs, resource utilisation and outcomes (per year) of modifying TIA service provision in hospital 1
| Original service (16 clinic slots per week) | Modified service (17 clinic slots per week) | Weekend service+17 clinic slots per week) | Weekend service+15 clinic slots per week) | Weekend service+13 clinic slots per week) | |
| Days operating per week | 5 | 5 | 7 | 7 | 7 |
| Total no of patients presenting | 491 | 490 | 490 | 491 | 491 |
| Cost of clinics used and unused | £340 000 | £361 000 | £366 000 | £346 000 | £325 000 |
| Major strokes post TIA (mean, 99% CI)* | 10.6 (10.4 to 10.8) | 10.7 (10.5 to 10.9) | 10.6 (10.4 to 10.8) | 10.8 (10.6 to 11.0) | 10.6 (10.4 to 10.8) |
| Poststroke deaths (mean, 99% CI)* | 3.0 (2.9 to 3.1) | 3.0 (2.9 to 3.1) | 3.0 (2.9 to 3.1) | 3.1 (3.0 to 3.2) | 3.0 (2.9 to 3.1) |
| No of high-risk breaches (%)† | 103 (69) | 32 (21%) | 6 (4%) | 7 (5%) | 8 (5%) |
| No of low-risk breaches (%)‡ | 7 (2) | 4 (1%) | 3 (1%) | 13 (4%) | 75 (22%) |
| Time from referral to clinic appointment for high-risk patients in days, median (IQR) | 1.15 (0.93–2.88) | 0.85 (0.17–0.99) | 0.68 (0.16–0.93) | 0.70 (0.15–0.93) | 0.86 (0.16–0.99) |
*Point estimate and 99% quasi CI reflecting the uncertainty from sampling in the model, not any uncertainty in model parameters. 99% was chosen because of multiple values were compared.
†High-risk breaches were defined as high-risk patients not seen by a specialist within 24 hours of initial clinic referral.12
‡Low-risk breaches were defined as low-risk patients not seen by a specialist within 7 days of initial clinic referral.
Of the ~490 patients in the model, 340 are considered low risk (294 TIA mimic; 46 low-risk TIA) and 150 are considered high risk (116 high-risk TIA; 34 minor stroke).
TIA, transient ischaemic attack.