title: The effect of transient ischemic attack clinical pathway.
abstract: BACKGROUND
  Clinical pathway (CP) of transient ischemic attack (TIA) is an interdisciplinary, comprehensive, standardized management model for medical care of TIA. It aims to standardize the procedure, reduce the cost, and improve the quality of medical care. However, its effect is still unclear.
  
  
  OBJECTIVE
  To evaluate the effect of TIA CP and provide evidence for control of medical care cost, optimize the structure of hospital cost, and make best use of medical resource.
  
  
  METHODS
  112 patients in the CP group and 179 patients in the nonclinical pathway (NCP) group were included in this nonconcurrent cohort study.
  
  
  RESULTS
  The average length of stay was 9.55 ± 3.89 days in the NCP group, and it was 7.26 ± 2.09 days in the CP group. The average length of stay was significantly shortened by 2.29 days. Hospital cost in the CP group significantly increased by 7.9% (868 yuan) compared with that in the NCP group. The proportion of medication cost significantly decreased by 5%, while the proportion of examination cost significantly increased by 8%. As for the clinical outcomes of patients with TIA, 98.21% of the patients in the CP group were discharged in a good condition, while the proportion was 97.77% in the NCP group, and no significant difference was found between the improvement rate of the two groups. Eight patients (4%) in the NCP group were admitted to the hospital because of a 30-day recurrent TIA or cerebral infarction; four of them had cerebral infarction, whereas no recurrent TIA or cerebral infarction was found in the CP group at the 30-day follow-up.
  
  
  CONCLUSIONS
  Implementation of TIA CP could reduce the length of stay, the proportion of medication cost, and optimize the structure of hospital expense, thus making best use of medical resources and improve the quality of TIA medical care.
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Huang
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Chunqiu
authors.initials: C
authors.lastname: Fan
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Jianping
authors.initials: J
authors.lastname: Jia
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Lihong
authors.initials: L
authors.lastname: Wang
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Li
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Wu
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Yingmei
authors.initials: Y
authors.lastname: Deng
authors.affiliation: From the Dept. of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China (XH, CF, JJ, LW, JW); Dept. of Medical Affair, Xuan Wu Hospital, Capital Medical University, Beijing, China (XL, YW); and Medical Records and Statistic Office, Xuan Wu Hospital, Capital Medical University, Beijing, China (YD).
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis; D004632:Emergency Medical Services / Q000191:economics / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome