Döngüsel Sağlık Hizmeti Ekonomisine Yönelik Sistemik Dönüşüm İçin Bir Zorluk: Tek-Kullanımlık mı, Değil mi?

Yıl 2022, , 832 - 847, 27.09.2022

Hüseyin Demir , Merve Tekinarslan

https://doi.org/10.37989/gumussagbil.1139520

Öz

Çalışma sağlık hizmeti ekonomisinin sistemik dönüşümünün zorluğunu DAS süreci bağlamında değerlendirmeyi amaçlamıştır. Veri elde etmede Web of Science (WoS) veri tabanı kullanılmıştır. R ortamında biblioshiny aracılığıyla çeşitli analizler yürütülmüştür. Tanımlayıcı bulgular sunulduktan sonra trend kelime, trend kelime ağırlıkları ve bunlara ilişkin görseller elde edilmiştir. Trend kelimelerin yıllara göre gelişim seyrinin değerlendirilmesinde çoklu uyum analizi, görselleştirmede ise ggplot2 paketi kullanılmıştır. Yayınlarda öne çıkan döngüsel yaklaşım kavramları sahadan bilgi ve deneyimlerle desteklenerek sağlık hizmeti ekonomisinin sistemik dönüşümünün zorluğuna dikkat çekilmeye çalışılmıştır. Alandaki yayın ve atıf sayısı artış trendi göstermiştir. Öne çıkan çalışmalar enfeksiyon kontrolü, diyaliz, anestezi ve analjezi alanından gelmektedir. Trend kelimeler; ömür devri değerlendirmesi, yeniden kullanım, sterilizasyon, yeniden işleme vb. kavramların yüksek merkezilik ve yoğunluk düzeyine sahip olduğunu göstermiştir. Benzer biçimde çoklu uyum analizi bulguları yakın tarihli çalışmalarda DAS süreçlerine fazlaca vurgu yapıldığını ortaya koymuştur. Bulgular doğrusal sağlık hizmeti ekonomisinden döngüsel sağlık hizmeti ekonomisine yönelik sistemik dönüşümün hastane yönetimleri üzerinde zorluklar yaratacağını açık bir biçimde göstermektedir. Dolayısıyla sağlık hizmetinin hastane düzeyinde sürdürülebilirliği için salt döngüsel yaklaşım yerine tek-kullanımlık malzeme kullanımına devam edildiği hibrit bir yaklaşımın faydalı olacağı değerlendirilmektedir.

Anahtar Kelimeler

Sağlık Hizmeti, Doğrusal Ekonomi, Döngüsel Ekonomi, Tek-Kullanım, Yeniden Kullanım

A Challenge for Systemic Transformation towards Circular Healthcare Economy: Single-Use or Not?

Öz

The study aims to discuss the challenge of systemic transformation of healthcare economy in the context of disinfection and sterilization (DAS) process. The database of the Web of Science (WoS) has been used to obtain data. In R environment, a variety of analyzes have been conducted through the biblioshiny. Following the descriptive findings, trend words, trend word weights and related visuals have been obtained. Multiple correspondence analysis was used to evaluate the development course of trending words by year, and the ggplot2 package has been used to visualization. An attempt has been made to draw attention to the difficulty of the systemic transformation of the healthcare economy by supporting the circular approach concepts featured in the publications with knowledge and experience from the field. The number of publications and citations in the field has shown an increasing trend. Prominent studies have been conducted in the areas of infection control, dialysis, anesthesia, and analgesia. Trend words have shown that life cycle assessment, reuse, sterilization, reprocessing, etc. concepts have a high level of centricity and concentration. Similarly, multiple correspondence analysis findings have shown that a heavy reliance has been placed on DAS processes in recent studies. The results clearly show that the systemic transformation from a linear healthcare economy to a circular one will create challenges for hospital administrations. It is therefore assessed that a hybrid approach to the continued use of disposable products instead of a purely circular approach will be beneficial to the sustainability of healthcare.

Anahtar Kelimeler

Healthcare, Linear Economy, Circular Economy, Single-Use, Reuse

Kaynakça

• 1. Wang, D. and Wu, J. (2019). Reprocessing and Reuse of Single-Use Medical Devices in China : A Pilot Survey. BMC Public Health, Vol. 19, No. 461, 1-10.
• 2. Macneill, B. A. J., Hopf, H., Khanuja, A., Alizamir, S., Bilec, M., Eckelman, M. J., Hernandez, L., McGain, F., Simonsen, K., Thiel, C., Young, S., Lagasse, R. and Sherman, J. D. (2020). Transforming the Medical Device Industry: Road Map to a Circular Economy. Health Affairs, Vol. 39, No. 12, 2088-2097.
• 3. Grantcharov, P. D., Boillat, T., Elkabany, S., Wac, K. and Rivas, H. (2019). Acute Mental Stress and Surgical Performance. British Journal of Surgery Society, Vol. 3, No. 1, 119-125.
• 4. Roth, K., Heeg, P. and Reichl, R. (2002). Specific Hygiene Issues Relating to Reprocessing and Reuse of Single‐Use Devices for Laparoscopic Surgery. Surgical Endoscopy, Vol. 16, No. 7, 1091-1097.
• 5. Sherman, J. D. and Hopf, H. W. (2018). Balancing Infection Control and Environmental Protection as a Matter of Patient Safety: The Case of Laryngoscope Handles. Anesthesia & Analgesia, Vol. 127, No. 2, 576-9.
• 6. Marshall, D. C., Dagaonkar, R. S., Yeow, C., Peters, A. T., Tan, K., Abisheganaden, J. and Verma, A. (2017). Experience with the Use of Single-Use Disposable. Journal of Bronchology & Interventional Pulmonology, Vol. 24, No. 2, 136-143.
• 7. Lilja, C., Julia, T. and Lars, K. (2017). Early Assessment of the Likely Cost Effectiveness of Single-Use Flexible Video Bronchoscopes. PharmacoEconomics - Open, Vol. 1, No. 2, 133-141.
• 8. Mouritsen, J. M., Ehlers, L., Kovaleva, J. and Ahmad, I. (2020). A Systematic Review and Cost Effectiveness Analysis of Reusable vs. Single-Use Flexible Bronchoscopes. Anaesthesia, Vol. 75, 529-540.
• 9. Coase, R. H. (1937). The Nature of the Firm. Economica, Vol. 4, No. 16, 386-405.
• 10. Williamson, O. E. (1975). Transaction-Cost Economics: The Governance of Contractual Relations. Journal of Law and Economics, Vol. 22, No. 2, 233-261.
• 11. Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart G. L. and Torrance, G. W. (2015). Methods for the Economic Evaluation of Health Care Programmes. United Kingdom: Oxford University Press.
• 12. Ayres, R. U. (1994). Industrial Metabolism: Theory and Policy. (Edited by Braden R. Allenby and Deanna J. Richards). The Greening of Industrial Ecosystems. USA: National Academy Press, 23-37.
• 13. Kane, G. M., Bakker, C. A. and Balkenende, A. R. (2018). Towards Design Strategies for Circular Medical Products. Resources, Conservation & Recycling, Vol. 135, 38-47.
• 14. Rutala, W. A., Weber, D. J. and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2008). Guideline for Disinfection and Sterilization in Healthcare Facilities. https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines-H.pdf. Erişim Tarihi: 30.12.2020.
• 15. Hakim, S. A., Mohsen, A. and Bakr, I. (2014). Knowledge, Attitudes and Practices of Health-Care Personnel towards Waste Disposal Management at Ain Shams University Hospitals, Cairo. Eastern Mediterranean Health Journal, Vol. 20, No. 5, 347-354.
• 16. World Health Organization Regional Office for Europe. (2018). Circular Economy and Health: Opportunities and Risks. https://www.euro.who.int/__data/assets/pdf_file/0004/374917/Circular-Economy_EN_WHO_web_august-2018.pdf. Erişim Tarihi: 15.1.2021.
• 17. McGain, F., Story, D., Lim, T. and McAlister, S. (2017). Financial and Environmental Costs of Reusable and Single-Use Anaesthetic Equipment. British Journal of Anaesthesia, Vol. 118, No. 6, 862-869.
• 18. R Core Team (2021). R: A Language and Environment for Statistical Computing. Austria: R Foundation for Statistical Computing.
• 19. Aria, M. and Cuccurullo, C. (2017). Bibliometrix: An R-tool for Comprehensive Science Mapping Analysis. Journal of Informetrics, Vol. 11, No. 4, 959-975.
• 20. Kerber, R. (2005). Device Makers Fight Reuse of Surgical Tools. USA: Boston Globe.
• 21. Collignon, P. J., Dreimanis, D. E. and Beckingham, W. D. (2003). Reuse of Single-Use Medical Devices in Sterile Sites: How Often Does This Still Occur in Australia? Medical Journal of Australia, Vol. 164, No. 9, 115-116.
• 22. Koh, A. and Kawahara, K. (2005). Current Practices and Problems in the Reuse of Single-Use Devices in Japan. Journal of Medical and Dental Sciences, 52, 81-89.
• 23. Koçel, T. (2015). İşletme Yöneticiliği. İstanbul: Beta Yayınları.
• 24. Rutala, W. A. and Weber, D. J. (2014). Selection of the Ideal Disinfectant. Infection Control & Hospital Epidemiology, Vol. 35, No. 7, 855-865.
• 25. Rutala, W. A. and Weber, D. J. (2013). Disinfection and Sterilization: An Overview. American Journal of Infection Control, Vol. 41, No. 5, 2-5.
• 26. Rutala, W. A. and Weber, D. J. (2016). Disinfection and Sterilization in Health Care Facilities: An Overview and Current Issues. Infectious Disease Clinics of North America, Vol. 30, No. 3, 609-637.
• 27. Alfa, M. J. (2013). Monitoring and Improving the Effectiveness of Cleaning Medical and Surgical Devices. American Journal of Infection Control, Vol. 41, No. 5, 56-59.