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Transportation Factors and Postoperative Attendance and Weight Loss Through 24 Months

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Abstract

Purpose

Transportation, access to follow-up care, and association with weight loss are understudied in the bariatric population. The objective of this study was to determine how transportation variables associate with postoperative attendance and weight loss through 24 months.

Materials and Methods

Seven hundred eighty-seven patients (81.3% female; 59.1% White) who had primary surgery (48.6% gastric bypass) from 2015 to 2019 were included. Sidewalk coverage and number of bus stops from patients’ homes, driving distance in miles and minutes from patients’ homes to the nearest bus stop and the clinic were measured. Bivariate analyses were conducted with the transportation variables and attendance and %TWL at 2 or 3, 6, 12, and 24 months. One mixed multilevel model was conducted with dependent variable %TWL over 24 months with visits as the between-subjects factor and covariates: race, insurance, surgical procedure, and driving distance to the clinic in minutes, attendance, and %TWL over 24 months; an interaction between distance, attendance, and visits.

Results

There were no significant differences between the majority of the transportation variables and postoperative attendance or %TWL. Patients who had perfect attendance had improved %TWL at 12 months [t(534)=−1.92, p=0.056] and 24 months [t(393)=−2.69, p=0.008] compared to those who missed at least one appointment. Patients with perfect attendance and who had shorter driving times (under 20 min) to the clinic had greater weight loss through 24 months [F(10, 1607.50)=2.19, p=0.016)].

Conclusions

Overall, transportation factors were not associated with attendance and weight loss, with the exception of the interaction between shorter driving minutes to follow-up and perfect attendance.

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Funding

This study was funded by The Ohio State University Center for Clinical and Translational Sciences Artificial Intelligence and Machine Learning in Translational Science and Human Health Pilot Grant. 06/2021-05/2022. Pratt KJ (PI); Co-Is: Focht BC, Hanks A, Noria S, Outrich M. 06/2021-05/2022. Integrating Multiple Data Sources to Identify Bariatric Surgical Disparities in Franklin County.

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Authors and Affiliations

  1. Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA

    Keeley J. Pratt, Andrew S. Hanks & Brian C. Focht

  2. Department of General Surgery, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA

    Keeley J. Pratt

  3. Department of Geography, Center for Urban and Regional Analysis, The Ohio State University, Columbus, OH, 43210, USA

    Harvey J. Miller, Sabrena Noria, Stacy Brethauer & Bradley Needleman

Authors
  1. Keeley J. Pratt
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  2. Harvey J. Miller
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  3. Andrew S. Hanks
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  4. Brian C. Focht
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  5. Sabrena Noria
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  6. Stacy Brethauer
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  7. Bradley Needleman
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Corresponding author

Correspondence to Keeley J. Pratt.

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Key Points

• There were no significant differences between the majority of the transportation variables and attendance or %TWL at any of the postoperative assessments.

• Patients who had perfect attendance through 24 months had improved %TWL at 12 months and 24 months compared to those who missed at least one appointment.

• Patients with perfect attendance and who had shorter driving times (under 20 min) to the clinic had greater weight loss through 24 months.

• Future research should consider how telemedicine visits may aid patients with greater travel times and more socioeconomic need.

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Pratt, K.J., Miller, H.J., Hanks, A.S. et al. Transportation Factors and Postoperative Attendance and Weight Loss Through 24 Months. OBES SURG 34, 114–122 (2024). https://doi.org/10.1007/s11695-023-06906-7

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  • DOI: https://doi.org/10.1007/s11695-023-06906-7

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