S. Monfared1, D. Selzer1, A. Butler1 1Indiana University School Of Medicine,Bariatric And Minimally Invasive Surgery,Indianapolis, IN, USA
Introduction:
Patients seeking bariatric surgery are traveling longer distances to reach Metabolic and Bariatric Centers of Excellence. The purpose of this study was to evaluate the impact of travel distance on adherence to follow up and outcomes after bariatric surgery.
Methods:
A retrospective review of all consecutive patients who had undergone bariatric surgery at a Center of Excellence from June 1, 2013 to May 30, 2014 was performed. The patients were divided into two groups: those who traveled 50 miles or less and those who traveled more than 50 miles. Demographic data was obtained including age, gender, initial body mass index (BMI), type of surgery and insurance type. Primary outcome assessed was the influence of distance on postoperative weight loss over 4-year follow up period. Secondary outcomes assessed were follow-up compliance, length of stay (LOS), 30-day complication and readmission rates.
Results:
A total of 231 patients underwent bariatric surgery at our institution during that year with 4 years of follow up available. Of these, 147 patients traveled 50 miles or less and 84 patients traveled greater than 50 miles. Patient demographics were similar between the two groups. There was no difference in percent excess weight loss at each follow visit between the two cohorts (Figure 1). Furthermore, there was no difference in readmission rates (2% in ≤50 mile group vs 5% in > 50 mile group), minor complications rates (13% vs 10%), major complications rates (3% vs 2%) and LOS (2.6 vs 2.6 days). Over the four year period, patients who lived within 50 miles of the surgery center followed up an average of 5.6 out of 9 required visits which was statistically greater than an average of 4.6 visits for those who lived greater than 50 miles away.
Conclusion:
As expected, distance impacted long term follow up, but despite longer travel, there was no difference in bariatric patients’ postoperative weight loss success, length of stay, 30-day complication or readmission rates. Travel distance should not be a significant factor to providing patients with access to bariatric surgery at a Center of Excellence.
