Impact of distance on postoperative follow-up in patients of pediatric surgery: a retrospective review. Issue 4 (21st December 2020)

• Record Type: Journal Article
• Authors: Wiebe, Meagan E; Shawyer, Anna C
• Is Part Of: World journal of pediatric surgery. Volume 3:Issue 4(2020)
• Publication Date: 2020-12-21
• Subjects: health services research; Children -- Surgery -- Periodicals; 617.98
• DOI: 10.1136/wjps-2020-000195
• Languages: English
• ISSNs: 2516-5410

Abstract

Abstract : Objective: Centralization 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. Methods: We 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. Results: We 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. Conclusions: Patients 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.