Comparison of hospital medical waste generation rate based on diagnosis-related groups

In recent years, a wider range of people and organizations have paid increasing attention to the potential harm from medical waste. Medical waste-generation assessment is the first step in the continuing improvement of hospital medical waste management. The results could be used for planning, budgeting, cost controlling, and optimizing waste-management systems. It also provides an opportunity to compare with other hospitals. Because medical waste-generation rate is not a homogeneous indicator without considering the differences of the hospital's scale, type, specialization, technical level, quality, and efficiency, people cannot simply use the generation rate to compare performance between hospitals. A way to adjust the indicator before comparison is needed. This study collected data of annual quantity of medical waste, number of beds, inpatient occupancy rate, number of diagnosis-related groups, and case-mix index. The medical waste generation rate, diagnosis-related groups score, case-mix index score, and adjusted generation rate were calculated. The comparisons were conducted by dividing included hospitals into groups according to level and affiliation. Before adjustment, level 3 hospitals had higher generation rate than level 2 hospitals; hospitals subjected to district health bureaus had lower generation rate than hospitals subjected to Ministry of Health and Beijing Health Bureau. After adjustment, level 3 became the lower one. The group of Ministry of Health was still the highest; the lowest one changed from group of district health bureaus to group of Beijing Health Bureau. It shows the relations between diseases' coverage, complexity a hospital treated and medical waste generation. Although the effects on generation rate by medical activities in outpatient department need to be studied further, and the application is limited by the support of a full equipped hospital information system and a sound quality control of clinical data, it is still a simple and operable tool to compare the performance of hospital medical waste management.