Impact of distance on postoperative follow-up in patients of pediatric surgery: a retrospective review

Abstract

ObjectiveCentralization of medical services in Canada has resulted in patients travelling long distances for healthcare, which may compromise their health. We hypothesized that children living farther from a children’s hospital were offered and attended fewer follow-up appointments.MethodsWe reviewed children less than 17 years of age referred to the general surgery clinic at a tertiary children’s hospital during a 2-year period who underwent surgery. Descriptive statistics were performed.ResultsWe identified 723 patients. The majority were male (61%) with a median age of 7 years (range 18 days to16 years) and were from the major urban center (MUC) (56.3%). The median distance travelled to hospital for MUC patients was 8.9 km (range 0.9–22 km) vs 119.5 km (range 20.3–1950 km) for non-MUC patients. MUC children were offered more follow-up appointments (72.7% vs 60.8%, p<0.05). No significant differences existed in follow-up attendance rates (MUC 88.5% vs non-MUC 89.1%, p=0.84) or postoperative complications (9.8% vs 9.2%, p=0.78). There were no deaths.ConclusionsPatients living farther from a hospital were offered fewer follow-up appointments, but attended an equivalent rate of follow-ups when offered one. Telemedicine and remote follow-up are underused approaches that can permit follow-up appointments while reducing associated travel time and expenses.

Determining the Clinical Value of Routine Post-operative follow-up in Common Paediatric Surgical Conditions: Prospective Observational Study

“…The 723 patients were divided into two groups as per distance from the major urban centre, and the study highlighted no signi cant difference in follow-up rates between the two groups. [13] Gimon et al also found that de ned follow-up order is a signi cant factor in determining the mode of follow-up.…”

Determining the clinical value of routine post operative follow up in common paediatric surgical conditions: A prospective observational study

“…The 723 patients were divided into two groups as per distance from the major urban center, and the study highlighted no significant difference in follow-up rates between the two groups. [ 13 ] Gimon et al also found that defined follow-up order is a significant factor in determining the mode of follow-up. However, in their study, parents living nearby were also an independent factor in determining the mode of follow-up.…”