title: Travel distance, age, and sex as factors in follow-up visit compliance in the post-gastric bypass population.
abstract: BACKGROUND
  There is no consensus regarding the optimal rate of follow-up in the post-bariatric surgery patient population.
  
  
  METHODS
  The records of all patients who underwent laparoscopic Roux-en-Y gastric bypass from 2001 to 2003 were reviewed. Using patient zip codes, travel distances were calculated between the patients' places of residence and our clinic. Patients were then assigned to 1 of 3 cohorts according to the following distances: (1) < 50 miles, (2) 50 to 100 miles, and (3) > 100 miles. Patient compliance with follow-up appointments at 3 weeks, 3 months, 6 months, 9 months, and 12 months was analyzed. Linear trends were identified using the Mantel-Haenszel test. Age and sex were analyzed as possible predictors of compliance using the chi(2) test. P values < .05 were considered statistically significant.
  
  
  RESULTS
  The study group comprised 150 patients (127 females and 23 males). The 3 cohorts contained 115, 21, and 14 patients, respectively. All patients in each cohort were compliant with the 3-week follow-up appointment. Although there were differences in compliance between cohorts at each of the remaining appointments, only the 9-month (70.3% vs 61.9% vs 35.7%) visit showed statistical significance (P = .035). The 6-month visit trended toward significance (85.2% vs 76.2% vs 64.3%; P = .088). Males were more likely to be compliant with the 12-month follow-up (P = .040). When controlling for sex, travel distance was also a predictor of compliance at this follow-up visit (P = .024). Age was not predictive of compliance (P = .827).
  
  
  CONCLUSIONS
  Based on our findings, we conclude that travel distance from the clinic does not significantly affect compliance at the initial follow-up, 3-month, and 12-month appointments. However, distance does tend to affect compliance at the 6-month appointment and significantly affects compliance at the 9-month appointment. Males are more likely to be compliant at the 12 month follow-up visit. We must continue to strive for 100% follow-up in our post-bariatric surgery patients.
authors.affiliation: Gundersen Lutheran Medical Center, La Crosse, Wisconsin, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Lara
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Baker
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Larson
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mathiason
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Lambert
authors.forename: Shanu N
authors.initials: SN
authors.lastname: Kothari
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D015390:Gastric Bypass; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011184:Postoperative Period; D012189:Retrospective Studies; D012737:Sex Factors; D014195:Travel