ECRI research examines safety, cost, and environmental tradeoffs of reusing versus discarding medical devices in hospitals.
One way healthcare providers attempt to reduce hospital-acquired infections is to discard medical devices following use rather than disinfect and reuse them—but this practice carries significant cost and environmental implications. ECRI released a series of assessments analyzing the evidence surrounding single-use versus reused or reprocessed medical devices in hospital settings.
The research was conducted by the ECRI-Penn Evidence-based Practice Center and involved a systematic literature review of more than 2,000 studies, primarily focused on devices used for hospital-acquired infections prevention, such as hospital gowns and bedside care devices, including laryngoscopes. The research also includes other types of scopes and surgical items.
Each assessment report includes a chart that indicates whether the available evidence supports single use, reuse, or is inconclusive across clinical, economic, and environmental categories. The findings emphasize that local factors such as infection rates, supplier agreements, reuse frequency, and reprocessing methods influence outcomes and should be considered.
Key findings:
- Clinical impact: Clinical outcomes sometimes favored single-use disposable devices depending on the specific device, particularly for infection rates.
- Economic considerations: Economic analyses of single-use versus reusable devices gave mixed findings, though in most categories, reusable devices are less costly.
- Environmental footprint: Environmental impact evidence often favored reused or reprocessed devices, as disposable devices are more harmful for the environment.
While single-use devices are often favored for infection prevention, the evidence supporting this is not consistent across all device types, and reusable options often present economic and environmental advantages. The research highlights the complex tradeoffs between clinical outcomes, economic costs, and environmental impact when choosing between single-use disposable and reusable or reprocessed medical devices.
The assessments, organized by device category, have been made publicly accessible and can be downloaded at this link. ECRI members can access the evidence assessments through ECRI’s member portal.
“There’s no one-size-fits-all solution when it comes to choosing between single-use and reusable medical devices,” says ECRI’s director of clinical evidence Evan LeGault in a release. “These assessments are designed to support hospitals, supply chain professionals, infection control teams, and sustainability officers in weighing the tradeoffs and identifying what works best for their organization.”
Research Process and Evidence Gaps
ECRI searched for primary studies and systematic reviews comparing single-use and reused or reprocessed medical devices for in-hospital use. The systematic literature search captured publications from Jan 1, 2021, to Jan 6, 2025, and identified 2,133 citations to screen, ultimately yielding 48 studies in 21 device categories.
Substantial gaps exist in the current evidence base, with clinical outcomes and economic costs reported far less frequently than environmental impact, and most of the 21 device categories were examined by few studies. In the absence of strong direction from clinical or economic evidence, environmental impacts may become a deciding factor.
This study highlights the need for further research as well as increased transparency from manufacturers, reprocessing companies, and healthcare institutions.
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