Benefits and costs of alternative healthcare waste management: an example of the largest hospital of Nepal.

BACKGROUND Management of health-care waste is an essential task, which has important consequences for public health and the well-being of society. Economic evaluation is important for strategic planning and investment programming for health-care waste management (HWM). A cost-benefit analysis of an alternative method of HWM in Bir hospital, Nepal was carried out using data recently collected from primary sources. METHODS Data were collected using mixed quantitative and qualitative methods. Costs and benefits were measured in Nepalese rupees. The values of all inputs were costs associated with the alternative HWM. Benefits were defined as the reduction in cost of transportation; money obtained from selling of recycled waste; and risk reduction, among others. Break-even analysis and calculations of benefit-cost ratio were used to assess the alternative HWM. RESULTS The alternative HWM reduces the cost of waste disposal by almost 33% per month, owing to reduction in the amount of waste for disposal. The hospital earns 3 Nepalese rupees per bed per day. The results suggest that a break-even point for costs and benefits occurs when 40% of the total beds of the hospital are covered by the alternative HWM, if the bed occupancy rate is at least 68%. If the alternative HWM is introduced in the hospital system, hospitals can reach the break-even point at 40 to 152 beds, depending on their performance in HWM. CONCLUSIONS The results show the economic feasibility and financial sustainability of the alternative HWM. This alternative method of HWM is a successful candidate for replication in all public and private hospitals in Nepal.