title: Travel distance and attrition in outpatient eating disorders treatment.
abstract: OBJECTIVE
  The purpose of this study was to investigate the impact of the distance patients had to travel for treatment on attendance patterns and treatment attrition.
  
  
  METHODS
  Contact information, clinical records, and/or appointment records of 209 adult patients presenting to an outpatient eating disorder treatment center over a specific period of time were reviewed. Information was obtained on demographics, diagnosis, number of appointments attended, cancelled, and failed, and termination status. Patients were classified as treatment completers or dropouts and compared on demographic, diagnostic, attendance, and distance to treatment site variables.
  
  
  RESULTS
  Treatment completer and dropout groups did not differ significantly on demographic variables, with the exception of employed patients being more likely to drop out of treatment. Although not statistically significant, patients diagnosed with bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) were more likely to drop out of treatment prematurely. Surprisingly, distance traveled to the treatment site was not significantly different between groups and did not appear to significantly impact attendance patterns.
  
  
  CONCLUSIONS
  Results of this archival investigation were unexpected and likely limited by the design. Results can be useful in understanding motivational factors inherent in noncompliance and premature termination of treatment. A prospective study including fine-grained analysis of variables associated with eating disorder treatment attrition is indicated.
authors.affiliation: Neuropsychiatric Research Institute, Fargo, North Dakota 58107, USA. lswan@nrifargo.com
authors.forename: Lorraine A
authors.initials: LA
authors.lastname: Swan-Kremeier
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Tasha
authors.initials: T
authors.lastname: Twardowski
authors.forename: Kathy
authors.initials: K
authors.lastname: Lancaster
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013223:Statistics as Topic; D014195:Travel