A staggering number of medical supplies—from surgical gloves to sponges to medications—go unused and are discarded after surgeries. Now, researchers at the University of California–San Francisco (UCSF) have put a price tag on that waste, according to a report from Kaiser Health News.
The authors quantified through direct observation every disposable supply that was unused at the end of surgery in 58 neurosurgical cases at UCSF in August 2015. Item costs (in U.S. dollars) were determined from the authors’ supply catalog, and statistical analyses were performed. The findings were published in the Journal of Neurosurgery.
Across the 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range: $89 to $3,640; median: $448), or 13% of total surgical supply costs. Univariate analyses revealed that the case type (cranial versus spinal), the case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and the surgeon were important predictors of the cost of unused surgical supplies. Case length and years of surgical training did not affect the percentage of unused supply cost. The authors estimated approximately $968 of operating room (OR) waste per case; $242,968 in OR waste per month; and $2.9 million in OR waste per year for their neurosurgical department.
Among the most unused and discarded supplies identified in the study were sponges, blue towels, and gloves. The most expensive item wasted, according to the study, was the Surgifoam absorbable gelatin sponge (Ethicon US), which is used to stop bleeding. One sponge can cost close to $4,000.
As health care costs continue to skyrocket, it is important to look for ways to contain them, said co-author Dr. Michael Lawton, a neurosurgeon at UCSF.
Lawton, who was also one of the 14 surgeons observed in the study, said he performs approximately 400 surgeries per year. If nearly $1,000 per procedure is being wasted on potentially reusable supplies, approximately $400,000 could be saved per year — for just one surgeon.
“These savings could translate into teaching and research opportunities, and also allow more patients to come in” for treatment, Lawton said.
The researchers also recommend price transparency for surgeons. A “feedback system,” Lawton explained, would allow them to compare where they stand relative to their peers in terms of cost per procedure. While not available yet, such a system could encourage better management of operating room supplies, he said.
Another potential way to limit waste is to review surgeons’ “preference cards”—the list of instruments and other items they request for each procedure. Removing unnecessary items from the list and clarifying which ones should be opened at the beginning of a procedure could help save supplies.