Predictors of one-year follow-up patient survey completion after bariatric surgery.
Masabni K, Carlin A, Varban O, Cassidy R, Bonham A, Stricklen A, Finks J, Ghaferi A. Predictors of one-year follow-up patient survey completion after bariatric surgery.. Surg Obes Relat Dis 2017; 13(10):S151.
Surg Obes Relat Dis
Background: The impact of bariatric surgery on comorbidity remission and quality of life requires long term evaluation of outcomes. Most MBSAQIP centers struggle to achieve lifelong, in-person, follow-up for bariatric surgery patients. An alternative strategy utilizes patient completed surveys. Identification of patient and site specific factors associated with survey completion may provide valuable information for practices seeking to maximize follow-up rates This study aims to identify factors that are associated with patients' completion rates of previously validated one-year follow-up surveys after bariatric surgery. Methods: Using clinical registry data from the Michigan Bariatric Surgery Collaborative, we included all patients who underwent bariatric surgery at 38 unique hospitals from January 2012 thru October 2015. Procedure type, demographic data, co-morbidities, and 30-day postoperative complications were evaluated for significant predictors of follow-up. Hospital specific rates of survey completion were compared. Results: A total of 24,781 patients underwent bariatric surgery during the study period and 11,125 (44.9%) completed one-year follow-up surveys. Compared to Roux-en-Y gastric bypass, the follow-up rate was lower after laparoscopic adjustable gastric banding (OR= 0.49; CI = 0.41-0.58) but higher after sleeve gastrectomy (OR= 1.22; CI= 0.82-1.80). Better follow-up was noted with annual household incomes 4 $10,000 (OR= 1.54; CI= 1.39-1.70), college graduates (OR= 1.38; CI= 1.28-1.49), older age (OR= 1.02; CI= 1.02-1.03) and those who were married or living with a significant other (OR = 1.3; CI= 1.23-1.37). Serious postoperative complications, private insurance, Black race, and tobacco use were associated with lower follow-up rates (all p< 0.0001). During the study period, average follow-up rates increased from 28% in 2012 to 52% in 2015 (Figure 1). Follow-up rates at the hospital level ranged from 0% to 81% per year. Six hospitals (16%) had persistently high follow-up rates (≥ 42% per year) while rates increased 20% to 40% in 10 hospitals (26%) and 4 40% in 9 hospitals (24%). Conclusion: Procedure type, socioeconomic factors and serious complications have significant associations with completion of one-year follow-up surveys after bariatric surgery. Certain hospitals had improved rates of follow-up indicating that hospitals pecific protocols may play an important role in obtaining followup data. Elucidation of these systematic follow-up protocols may allow optimization of long term data acquisition.