Integrated Medical Waste Management by Dynamics System Approach

In developing model of infectious medical waste management from hospitals in Bandung, there are four basic interacted variables: population (hospital patients), medical waste generator (in consideration with hospital capability), medical waste management (which using incinerator), and the cost of medical waste management. The developed model is designed to be an instrument to help with the best decision in medical waste system management in Bandung. The best decision, which is the lowest cost implied to the patients, is intended to increase community health on the end. Model simulation applied in this research is using system dynamics method. The reason for using this method is to anticipate the dynamics of system complexity and the feedback to design a policy. The behaviour of the developed model is close to actual condition, so it can be used as decision making model of medical waste management in Bandung. There is also indicated by the low value of RMSPE on stay-in-patients variable, which descend to 2.61%. Next from the model simulation can be predicted that the number of stay-in-patients is lesser, and so is the generation of medical waste. It is assumed that there is an increase in community health level in Bandung. From the simulation, we discovered that the best medical waste management for Bandung city is integrated management. The cost for integrated medical waste management (3th policy) is Rp 612 /kilogram, and the cost for one hospital is (1st policy) is Rp. 3077/kilogram and 2nd policy is Rp. 2360/kilogram. The cost implied to each patient for the 3th policy is Rp 165/bed/day, for the 1st policy is Rp 829/bed/day and for the 2nd policy is Rp 635/bed/day.