title: Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.
abstract: BACKGROUND
  In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions.
  
  
  METHODS
  We established a recovery and donation program to collect clean and unused supplies for healthcare institutions in developing nations. We analyzed items donated over a 3-year period (September 2010-November 2013) by quantity and weight, and estimated the projected value of the program under potential nationwide participation. To capture the health benefits attributable to the donated supplies at recipient institutions, we partnered with two tertiary-care centers in Guayaquil, Ecuador and conducted a pilot study on the utility of the donated supplies at the recipient institutions (October 2013). We determined the disability-adjusted life years (DALY) averted for all patients undergoing procedures involving donated items and estimated the annual attributable DALY as well as the cost per DALY averted both by supply and by procedure.
  
  
  RESULTS
  Approximately, 2 million lbs (907,185 kg) per year of medical supplies are recoverable from large non-rural US academic medical centers. Of these supplies, 19 common categories represent a potential for donation worth US $15 million per year, at a cost-utility of US $2.14 per DALY averted.
  
  
  CONCLUSIONS
  Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Bloomberg 7314B, 1800 Orleans St., Baltimore, MD, 21287, USA, ewan1@jhu.edu.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Wan
authors.forename: Li
authors.initials: L
authors.lastname: Xie
authors.forename: Miceile
authors.initials: M
authors.lastname: Barrett
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Baltodano
authors.forename: Andres F
authors.initials: AF
authors.lastname: Rivadeneira
authors.forename: Jonathan
authors.initials: J
authors.lastname: Noboa
authors.forename: Maya
authors.initials: M
authors.lastname: Silver
authors.forename: Richard
authors.initials: R
authors.lastname: Zhou
authors.forename: Suzy
authors.initials: S
authors.lastname: Cho
authors.forename: Tammie
authors.initials: T
authors.lastname: Tam
authors.forename: Alp
authors.initials: A
authors.lastname: Yurter
authors.forename: Carol
authors.initials: C
authors.lastname: Gentry
authors.forename: Jorge
authors.initials: J
authors.lastname: Palacios
authors.forename: Gedge D
authors.initials: GD
authors.lastname: Rosson
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Redett
mesh_terms: D000328:Adult; D000368:Aged; D002608:Charities / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004484:Ecuador; D005260:Female; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics*; D010865:Pilot Projects; D011634:Public Health; D019057:Quality-Adjusted Life Years; D013523:Surgical Equipment / Q000191:economics / Q000600:supply & distribution*