"无废医院"视角下上海市社区卫生服务机构医疗废物管理的现状与建议OA

Objective This study aims to analyze the current status of medical waste(MW)generation and management in community health service centers(CHSCs)in Shanghai,and to inform the city's"Zero-Waste Hospital"initiative.Methods A total of 100 CHSCs in Shanghai were selected via random sampling.A questionnaire,developed through a literature review,was administered in 2024 to collect data on infrastructure,service capacity,and MW generation for the year 2023.A questionnaire,designed based on literature review,was distributed in 2024 to collect data on infrastructure,service scale,and MW generation for the year 2023.Meanwhile,field investigations were conducted at three CHSCs to track the entire process of MW management,including classification,collection,transfer,temporary storage,and disposal.Origin software was employed to fit the correlation between outpatient volume and total MW generation in CHSCs without inpatient departments,and to calculate the average MW generation per outpatient visit.The MW generation coefficient per bed was then derived.These two indicators are used to measure the MW generation intensity.Results A total of 83 questionnaires were returned,of which 82 were valid.The data fitting results revealed a linear correlation between outpatient volume and MW generation across the surveyed CHSCs,with an average of 1 kg of MW generated per 58 outpatient visits and the MW generation coefficient per bed was 0.35 kg/(bed·day).The estimated MW generation coefficient per bed was 0.35 kg/(bed·day),with a 95%confidence interval(CI)of 0.24-0.46 kg/(bed·day)and a 99%CI of 0.20-0.50 kg/(bed·day).Field investigations found that all surveyed CHSCs had established MV collection,transfer,and temporary storage facilities based on available resources,with information technology systems equipped throughout to record MW information.Conclusions CHSCs in Shanghai demonstrated a solid foundation in MW management,a high level of digitalized administration,and a relatively low MW generation intensity compared with other regions in China.However,deficiencies were identified in management standardization and precision,as well as limited awareness and implementation of the"Zero-Waste"concept.This study suggested to strengthen the linkage mechanism of the whole society,improve the full cycle traceability system,and establish a diversified supervision and incentive mechanism to promote the"Zero-Waste Hospital"initiative in Shanghai.