Hastanelerde Tıbbi Atık Yönetiminde Güncel Eğilimler: Yöneylem Araştırması, Sürdürülebilirlik ve Dijitalleşmeyi Bütünleştiren Tematik Bir İnceleme

Öz

Tıbbi atık yönetimi; bulaşıcı hastalıklar, iklim değişikliği ve COVID-19 pandemisi gibi kriz dönemlerinde yaşanan hacimsel artışlar nedeniyle sağlık kurumları için stratejik bir öncelik hâline gelmiş ve son yıllarda sürdürülebilirlik, döngüsel ekonomi ve dijitalleşme odaklı önemli dönüşümler geçirmiştir. Bu tematik derleme, hastanelerde tıbbi atık yönetimine ilişkin mevcut akademik literatürü operasyonel ve yönetsel zorluklara odaklanarak ele almaktadır. Bulgular, literatürün önemli bir bölümünün yöneylem araştırması yaklaşımlarına odaklandığını; teknoloji ve yer seçimi için çok kriterli karar verme yöntemlerinin, lojistik ağ tasarımı ve araç rotalamada maliyet ve risk minimizasyonu için ise matematiksel modelleme ve sezgisel algoritmaların kullanıldığını göstermektedir. Sürdürülebilirlik paradigması, Çevresel, Sosyal ve Yönetişim ile Sürdürülebilir Kalkınma Amaçları çerçevelerinin tıbbi atık yönetimi süreçlerine entegre edilmesini gerektirmektedir. Bu kapsamda döngüsel ekonomi, kaynağında ayrıştırma ve atıktan enerji elde etme teknolojileri öne çıkmaktadır. Dijitalleşme optimizasyonu mümkün kılarken, paydaş katılımı ve eğitim başarının temelini oluşturmaktadır. Literatür taraması Web of Science, Scopus, PubMed ve Google Scholar veri tabanlarında belirlenen anahtar kelimeler kullanılarak yürütülmüş; ilgili çalışmalar başlık, özet ve tam metinleri incelenerek tematik sentez yaklaşımıyla analiz edilmiştir. Derleme sonucunda, çok kriterli karar verme modellerindeki öznellik, optimizasyon çalışmalarında gerçek dünya doğrulamasının yetersizliği ve dijital teknolojilerin etik ve veri yönetişimi boyutlarının sınırlı biçimde ele alınması temel araştırma boşlukları olarak belirlenmiştir. Gelecek çalışmalarda veri temelli karar destek sistemlerinin, hibrit karar modellerinin, ileri optimizasyon yaklaşımlarının ve gerçek hastane uygulamalarıyla yürütülecek doğrulama çalışmalarının dâhil edilmesinin önemli olduğu değerlendirilmektedir.

Anahtar Kelimeler

• ESG
• Tıbbi Atık Yönetimi
• Yöneylem Araştırması
• Optimizasyon
• Sürdürülebilir Kalkınma Amaçları (SKA)

Recent Trends in Medical Waste Management in Hospitals: A Thematic Review Integrating Operations Research, Sustainability, and Digitalization

Öz

Medical waste management has become a strategic priority for healthcare institutions due to volumetric increases experienced during crises, such as infectious diseases, climate change, and the COVID-19 pandemic, and has undergone significant transformations in recent years, focusing on sustainability, circular economy, and digitalization. This thematic review addresses the existing academic literature on medical waste management in hospitals, focusing on operational and managerial challenges. Findings indicate that a significant portion of the literature focuses on operational research approaches; multi-criteria decision-making methods are used for technology and location selection, while mathematical modeling and heuristic algorithms are used for cost and risk minimization in logistics network design and vehicle routing. The sustainability paradigm requires the integration of Environmental, Social, and Governance and Sustainable Development Goals frameworks into medical waste management processes. Circular economy, resource segregation, and waste-to-energy conversion technologies are emphasized. Digitalization enables optimization, whereas stakeholder engagement and training form the basis of success. The literature review was conducted using keywords identified in the Web of Science, Scopus, PubMed, and Google Scholar databases, and relevant studies were analyzed using a thematic synthesis approach by reviewing their titles, abstracts, and full texts. The review revealed that subjectivity in multi-criteria decision-making models, the lack of real-world validation in optimization studies, and the limited treatment of ethical and data governance dimensions of digital technologies are key research gaps. It is considered important for future studies to incorporate data-driven decision support systems, hybrid decision models, advanced optimization approaches, and validation studies with real hospital applications.

Anahtar Kelimeler

• ESG
• Medical Waste Management
• Operations Research
• Optimization
• SDGs

Kaynakça

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