This is a particular problem in the US, especially given the current uncertainty in how Americans are going to afford medical insurance now that President Donald Trump has scrapped the Affordable Care Act. Singapore too is predicted to have a hard year in terms of medical costs with the highest healthcare costs in the Asia-Pacific region this year.
High amounts of usable medical supplies are wastedAccording to a report published by the National Academy of Medicine in the US, an estimated $765 billion a year are lost in the wastage of medical supplies that are in a perfect, usable condition. A study conducted by researchers at the Department of Neurological Surgery at the University of California, quantified though direct observation, the number of usable supplies thrown away after 58 neurological surgeries conducted at the university.
They found the average cost of unused supplies was $653 or 13.1% of total surgical supply cost. Overall, this accounts for $2.9 million per year, for just one department, in one hospital.
There are a number of reasons for this degree of waste. Sometimes the products are past the use-by date provided on the container. Usually though, the products are perfectly within date but a new model of it has been introduced into the industry, or regulatory measures that mean once an item is placed in the room of a patient, it cannot be used for another, even if it was never opened.
There have also been instances where stocking spaces are not optimally utilised which means many unused supplies are thrown away when new ones are bought in.
NGOs stepping in with win-win solutions65-year-old Elizabeth McLellan however, has formulated a solution. Her nonprofit, Partners for Health, sends the neglected supplies to rural hospitals and developing countries. In a 15,000-square-foot warehouse in Portland, McLellan houses the supplies in shelves that climb from floor to ceiling.
There are unopened packages of syringes, diabetes supplies, surgical instruments that run hundreds of dollars apiece, boxes of IV fluids, bags of ostomy supplies and kits for obstetrics surgery. “There’s no reason to get rid of this,” she says.
In 2016, the organisation sent seven containers worth $250,000 overseas. A larger nonprofit, Georgia-based MedShare, sent 156 containers, each amounting to as much as $175,000 of cast-off medical goods. According to McLellan, much of it would otherwise end up in a landfill. One is being sent to Syria this week, and includes an ultrasound machine worth $25,000 and an infant warmer worth $3,995.
A report by the National Academy of Waste says that over-treatment, excess administrative costs and high prices are to blame. McLellan for her part hopes the medical community will put her out of business by fixing the issue, and she plans to speak to President Trump in the near future to bring it to his awareness.
Tackling the problem at the rootAnother way to combat this is by raising awareness amongst healthcare professionals and providing them with incentives to follow through.
Researchers at the University of California performed an experiment in which surgeons from multiple departments in multiple hospitals were divided into two groups. One group was told they would be given a bonus if they could reduce their medical cost requirements by at least 5% while the control was provided no incentive. The supply costs for the incentivised group dropped by 6.5%. The study noted that most surgeons are actually unaware of operating room costs.
Michael Lawton, a study co-author and one of the neurosurgeons examined, said the savings achieved by reducing the number of discarded and unused medical supplies "could translate into teaching and research opportunities, and also allow more patients to come in" for treatment. He proposed a ‘feedback system’ as an example that would allow surgeons to compare their wastage with their peers and encourage them to reduce theirs.
One strategy that the university is employing is to review the list of supplies that surgeons prefer for procedures, to identify those that are unnecessary and let nurses know which should be opened prior to surgery in the sterile field, versus those that can be opened in the operating room. MIMS
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