title: Improving access to bariatric surgery: early surgical and patient-focused outcomes of a rural obesity clinic.
abstract: BACKGROUND
  Bariatric surgery is typically offered in larger health care centers, forcing patients to travel long distances to access care. An adult obesity program was established in Whitehorse, Yukon based on the multidisciplinary adult bariatric clinic in Edmonton, to alleviate long-distance care difficulties. This study analyzes patient/health care staff satisfaction and surgical outcomes for this program.
  
  
  METHODS
  A survey was administered to patients and health care staff at Edmonton and Whitehorse. Patient charts were reviewed. A multivariate linear regression predicted the main effect of travel distance and other clinical covariates on follow-up compliance.
  
  
  RESULTS
  Postoperative body mass index, complications, and satisfaction scores were similar. Whitehorse patients had higher rates of follow-up (85.6% vs 71.1%, P = .002).
  
  
  CONCLUSIONS
  The Whitehorse Bariatric Program provides perioperative obesity care comparable to a larger center. Patient follow-up and satisfaction suggest a highly successful program. This may serve as a model for improving access to obesity services across Canada.
authors.affiliation: Division of General Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Angela W
authors.initials: AW
authors.lastname: Chan
authors.affiliation: Klondyke Medical Clinic, Whitehorse, Yukon, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Hopkins
authors.affiliation: Department of Family Medicine, Klondyke Medical Clinic, Whitehorse, Yukon, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gagnon
authors.affiliation: Royal Alexandra Hospital, 502 Community Services Centre, 10240 Kingsway Avenue, Edmonton, Alberta T5H 3V9, Canada. Electronic address: dbirch@ualberta.ca.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Birch
mesh_terms: D000328:Adult; D000416:Alberta; D000556:Ambulatory Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D050110:Bariatric Surgery / Q000379:methods / Q000706:statistics & numerical data*; D015992:Body Mass Index; D016208:Databases, Factual; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D058996:Quality Improvement; D012044:Regression Analysis; D019035:Rural Health Services; D011795:Surveys and Questionnaires
keywords: Obesity; Rural health care; Survey