Volume 28, Issue 3 (12-2025)
jha 2025, 28(3): 1-12 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Raadabadi M, Ahmadi Tehrani G, Nikomanesh P. Economic evaluation of hospital waste sterilization using outsourcing and government-managed methods in selected hospitals in Yazd. jha 2025; 28 (3) :1-12
URL: http://jha.iums.ac.ir/article-1-4677-en.html
URL: http://jha.iums.ac.ir/article-1-4677-en.html
1- Health Policy and Management Research Centre, Health Management and Policy Research Center, Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. , mehdiraadabadi@gmail.com
2- Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
3- Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. & Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2- Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
3- Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. & Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abstract: (135 Views)
Introduction: Hospital waste management poses a major challenge for health systems because of its infectious and hazardous nature. Waste disinfection has health, environmental, and financial implications. Although both outsourcing and in-house methods are used, evidence comparing their cost-effectiveness remains limited. This study aimed to conduct an economic comparison of these two methods in selected hospitals in Yazd, Iran.
Methods: This partial economic evaluation was conducted as a cost analysis in four public hospitals in Yazd. Data were collected using a researcher-made form through interviews with relevant experts and review of financial records. Costs were calculated as total annual cost, cost per kilogram of waste, and cost per active beds. Data were analyzed using Excel 2016.
Results: Hospital “A” generated the highest amount of waste (432,000 kg/year). The highest waste generation per active beds occurred in hospital “D” (917.2 kg/year). In terms of total annual cost, hospital “A” was the highest, while hospital “D” had the highest cost per active bed (approximately 4 million Iranian Rials= IRR). The highest cost per kilogram of waste was observed in hospital “C” (51,527 IRR). The cost differences between the two methods were statistically significant (p < 0.05).
Conclusion: The findings suggest that outsourcing hospital waste disinfection is more cost-effective than the in-house method. However, improper outsourcing can lead to inefficiency and additional costs. Therefore, conducting preliminary assessments and following recommended management steps, such as the Gartner Institute’s ten-step framework, is recommended before implementation.
Methods: This partial economic evaluation was conducted as a cost analysis in four public hospitals in Yazd. Data were collected using a researcher-made form through interviews with relevant experts and review of financial records. Costs were calculated as total annual cost, cost per kilogram of waste, and cost per active beds. Data were analyzed using Excel 2016.
Results: Hospital “A” generated the highest amount of waste (432,000 kg/year). The highest waste generation per active beds occurred in hospital “D” (917.2 kg/year). In terms of total annual cost, hospital “A” was the highest, while hospital “D” had the highest cost per active bed (approximately 4 million Iranian Rials= IRR). The highest cost per kilogram of waste was observed in hospital “C” (51,527 IRR). The cost differences between the two methods were statistically significant (p < 0.05).
Conclusion: The findings suggest that outsourcing hospital waste disinfection is more cost-effective than the in-house method. However, improper outsourcing can lead to inefficiency and additional costs. Therefore, conducting preliminary assessments and following recommended management steps, such as the Gartner Institute’s ten-step framework, is recommended before implementation.
Type of Study: Research |
Subject:
Health Economics
Received: 2025/07/5 | Accepted: 2025/11/21 | Published: 2025/12/8
Received: 2025/07/5 | Accepted: 2025/11/21 | Published: 2025/12/8
References
1. Zeraatkar E, Rahmani H, Ghazi Asgar M, Saeid Pour J, Azami S, Aryankhesal A. Waste management in selected hospitals of Teheran University of Medical Sciences: staff awareness and hospital performance-2012. Journal of Hospital. 2014;12(4):91-8. [In Persian] http://jhosp.tums.ac.ir/article-1-5214-en.html
2. Hadipour M, Afkhami M, Takdastan A. Identification and measurement of hospital waste materials and classification of them according to WHO criteria (case study: Amir-Al momenin hospital and ShahidRajaee polyclinic of Ahwaz). Jundishapur Journal of Health Sciences. 2011;3(1):39-51. [In Persian] https://jjhs.ajums.ac.ir/article_224088.html
3. Taghipour H, Hashemi AA, Mohammadpoorasl A. Training and monitoring of hospitals staffs concerning proper medical waste management. Medical Journal of Tabriz University of Medical Sciences. 2012;34(4):47-52. [In Persian] https://mj.tbzmed.ac.ir/Article/8025
4. Sharifi S, Yaghmaeian K, Golbaz S, Nabizadeh R, Baghani AN. Economic evaluation of hazardous healthcare waste treatment systems scientific reports. 2024;14(1): 21764 . [DOI:10.1038/s41598-024-69940-0]
5. Rashidian A, Alinia C, Majdzadeh R. Cost-effectiveness analysis of health care waste treatment facilities in Iran hospitals; a provider perspective. Iranian Journal of Public Health. 2015;44(3):352-60. https://ijph.tums.ac.ir/index.php/ijph/article/view/3645
6. Windfeld ES, Brooks MSL. Medical waste management-a review. Journal of Environmental Management. 2015;163:98-108. [DOI:10.1016/j.jenvman.2015.08.013]
7. Thakur V, Ramesh A. Healthcare waste management research: a structured analysis and review (2005-2014). Waste Management & Research. 2015;33(10):855-70. doi: [DOI:10.1177/0734242X15594248]
8. Alizadeh Z, Torabipour A. The obstacles of outsourcing in educational hospitals: a qualitative study. Journal of Qualitative Research in Health Sciences. 2018;7(2):204-13. [In Persian] https://jqr1.kmu.ac.ir/article_90931.html
9. Abbasi S, Sıcakyüz Ç, Gonzalez EDS, Ghasemi P. A systematic literature review of logistics services outsourcing. Heliyon. 2024;10(13): e33374. [DOI:10.1016/j.heliyon.2024.e33374]
10. Salmani M, Rashidian A, Abolhassani F, Majdzadeh R. Assessing experiences of outsourcing urban health posts: facilities and services offered in publicly owned and outsourced health posts in Tehran University of Medical Sciences. Hakim Journal. 2013;16(1):28-34. [In Persian] http://hakim.tums.ac.ir/article-1-1127-en.html
11. Joudaki H, Heidari M, Geraili B. Outsourcing of hospitals services: lessons learned from the experience. Journal of Health Based Research. 2015;1(1):13-23. [In Persian] http://hbrj.kmu.ac.ir/article-1-40-en.html
12. Karimi S, Agharahimi Z, Yaghoubi M. Impacts of outsourcing in educational hospitals in Iran: a study on Isfahan University of Medical Sciences-2010. Journal of Education and Health Promotion. 2012;1(25):1-5. doi: [DOI:10.4103/2277-9531.99959]
13. Motlagh M, Rahbar M, Kabir MJ. Decentralization of health system in Islamic Republic of Iran. Journal of Shahid Sadoughi University of Medical Sciences. 2008;16(3):322. [In Persian] http://jssu.ssu.ac.ir/article-1-584-en.html
14. Khan GM, Khan SU, Khan HU, Ilyas M. Challenges and practices identification in complex outsourcing relationships: a systematic literature review. PloS One. 2022;17(1): e0262710. [DOI:10.1371/journal.pone.0262710]
15. D'Souza BC, Seetharam AM, Chandrasekaran V, Kamath R. Comparative analysis of cost of biomedical waste management across varying bed strengths in rural India. International Journal of Healthcare Management. 2018;11(1):38-43. [DOI:10.1080/20479700.2017.1289438]
16. Chawla S, Gupta P, Mohanan A, Chawla P. Assessment of cost and resource utilization in hospital waste management in a tertiary care hospital. African Journal of Biomedical Research. 2024;27(6S):488-94. [DOI:10.53555/AJBR.v27i6S.6913]
17. Vaccari M, Tudor T, Perteghella A. Costs associated with the management of waste from healthcare facilities: an analysis at national and site level. Waste Management & Research. 2018;36(1):39-47. doi: [DOI:10.1177/0734242X17739968]
18. Sarabi Asiabar A, Azami-Aghdash S, Rezapour A, Alaei Kalajahi R, Taghizadeh S, Amuzadeh S, et al. Economic consequences of outsourcing in public hospitals in Iran: a systematic review. Journal of Health Administration. 2021;24(1):68-83. [In Persian] http://dx.doi.org/10.52547/jha.24.1.68 [DOI:10.52547/jha.24.1.68]
19. Karakolias S. Outsourcing non-core services in healthcare: a cost-benefit analysis. International Journal of Scientific Research and Management. 2024;12(10):1177-95. [DOI:10.18535/ijsrm/v12i10.mp01]
20. Bandaso A, Ayuningtyas D, editors. Management of medical waste in developing countries: a systematic review. The International Conference on Public Health Proceeding; 2023. [DOI:10.26911/the6thicph-FP.01.02]
21. Grimsey D, Lewis MK. Evaluating the risks of public private partnerships for infrastructure projects. International journal of project management. 2002;20(2):107-18. [DOI:10.1016/S0263-7863(00)00040-5]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Site Keywords
Health, Administration, Scientific Article, Iran University of Medical Sciences,
