An Integrated, Collaborative Multidisciplinary Clinic Improves 12-Month Follow-Up After Bariatric Surgery at a Single Veterans Affairs Medical Center

Background: To address the need for comprehensive, coordinated care of geographically dispersed veterans seeking bariatric surgery at a single veterans affairs (VA) medical center, we established an integrated multidisciplinary bariatric clinic. This resource-intensive clinic coordinates the care among primary care physicians, psychologists, physical therapists, and surgeons, in real time. Our hypothesis is that this integrated clinic will increase 1-year bariatric follow-up. Methods: This is a single institution retrospective review of bariatric surgery, comparing 12-month follow-up rates of veterans who had surgery before establishment of an integrated clinic (PRE) with those of veterans who had surgery after it was established (POST). Significant differences were determined using student's t-test and Fisher's exact test; p-values <0.05 were considered significant. Results: Of 221 bariatric patients, the average distance to the VA bariatric center was 262.1 miles. There were 97 patients in the PRE cohort and 124 in the POST cohort. Follow-up rates at 12 months were 76% in the PRE group compared with 85% in the POST group (p = 0.037). Conclusion: Veterans seeking weight loss surgery often travel large distances to the surgical center. A dedicated, integrated, multidisciplinary team approach to bariatric care significantly improves clinic follow-up in veterans undergoing bariatric surgery at a VA medical center.