Social Emergency Medicine
Background: Medical supplies are unevenly distributed throughout the world. Discarded medical materials in the United States that are viable for use can be recovered and allocated to low- and middle- income countries (LMICs), where poor access to medical supplies affects the delivery of adequate health care. Our objective was to develop a pilot program and describe, quantify, and monetize unused supplies from two urban, academic EDs in California for redistribution to LMICs.
Methods: We conducted this study at two urban EDs: a tertiary academic center with approximately 44,000 patients annually, and a level-one trauma center that serves approximately 77,000 patients per year. We trained ED staff to place opened, unused, uncontaminated medical supplies in strategically positioned bins located in each ED for 30 days. We sorted and quantified collected supplies, then used hospital-specific supply catalogs to determine the total cost of recovered medical supplies over the 30-day study period. We extrapolated the amount of collected medical supplies and associated costs to yearly estimates, as well as estimates that could be achieved with national implementation of this program.
Results: We recovered 43.3 kilograms ($6,635) of supplies from both the trauma and academic centers during the 30-day study period. The most commonly collected items included catheter needles (746), intravenous (IV) start supplies (308), cleansing supplies [such as alcohol preparation pads] (149), sutures (140), and phlebotomy tubes (101). The items of greatest value were open but unused procedure kits ($1,776), catheter needles ($1,009), sutures ($698), IV supplies ($621), and atomizer devices ($528). We estimated that both the trauma and academic centers produce $79,625 of unused medical supplies per year. If expanded to EDs across the country, similar programs would be capable of recovering approximately 1.2 million kilograms, or $189 million worth, of medical supplies annually.
Conclusions: We present a novel approach to decreasing medical supply surplus and recovering usable medical equipment. We found that a substantial quantity of valuable medical supplies can be recovered in two urban EDs. If our program were to be expanded nationally, considerable amounts of equipment could be responsibly redistributed and donated to other global health care facilities based on identified need.