Costs associated with the management of waste from healthcare facilities: An analysis at national and site level.

Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day-1 bed-1), paediatric and intensive care (3.37 kg day-1 bed-1) and gastroenterology-digestive endoscopy (3.09 kg day-1 bed-1). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg-1, with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.