摘要
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.
