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.

中文翻译：

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距离对儿科手术患者术后随访的影响：一项回顾性研究

目的 加拿大医疗服务的集中化导致患者长途跋涉就医，这可能会损害他们的健康。我们假设居住在离儿童医院较远的儿童接受了较少的随访预约。方法 我们回顾了 2 年期间转诊到三级儿童医院普通外科门诊并接受手术的 17 岁以下儿童。进行了描述性统计。结果 我们确定了 723 名患者。大多数是男性 (61%)，中位年龄为 7 岁（范围从 18 天到 16 岁），并且来自主要城市中心 (MUC) (56.3%)。MUC 患者前往医院的中位距离为 8.9 公里（范围 0.9-22 公里），而非 MUC 患者为 119.5 公里（范围 20.3-1950 公里）。MUC 儿童获得了更多的随访预约（72.7% 对 60.8%，p<0.05）。随访出勤率（MUC 88.5% vs 非 MUC 89.1%，p=0.84）或术后并发症（9.8% vs 9.2%，p=0.78）没有显着差异。没有死亡。结论 居住在离医院较远的患者获得的随访预约较少，但接受随访的比例相同。远程医疗和远程随访是未得到充分利用的方法，可以允许进行后续预约，同时减少相关的旅行时间和费用。结论 居住在离医院较远的患者获得的随访预约较少，但接受随访的比例相同。远程医疗和远程随访是未得到充分利用的方法，可以允许进行后续预约，同时减少相关的旅行时间和费用。结论 居住在离医院较远的患者获得的随访预约较少，但接受随访的比例相同。远程医疗和远程随访是未得到充分利用的方法，可以允许进行后续预约，同时减少相关的旅行时间和费用。