Quantifying Excess Home Health Equipment Following Head and Neck Surgery

Monday, October 13, 2025

2:48 PM - 2:54 PM EDT

Location: 109-110

Disclosure(s):

Kyle N. Polen, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Keshav V. Shah, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Steven B. Cannady, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: U.S. healthcare is one of the largest global contributors to waste and pollution, but the burden of discarded home health equipment is unknown. This study aims to quantify unused medical supplies following temporary home tracheostomy tube and nasogastric Dobhoff tube (DHT) care, assessing economic implications and patients’ perspectives.

Methods: Twenty-four patients discharged with a tracheostomy tube, DHT, or both were enrolled following head and neck cancer resection between June 1 to December 1, 2024 at the Hospital of the University of Pennsylvania. A follow-up survey was sent after decannulation and DHT removal. Quantitative questions queried the number of unused at-home supplies and durable medical equipment (DME prescribed at discharge). Open-ended qualitative questions assessed patient perspectives. Patients with tubes and lines removed prior to discharge, patients discharged to a facility, and patients with long-term dependence on a tracheostomy or DHT outside of the recovery period were excluded.

Results: From discharge to device removal, patients had home tracheostomies for 9.6 days and home DHTs for 12.2 days on average. The most prevalent excess items following tracheostomy care were inner cannulas, French suction catheters, and tracheostomy ties. For DHT management, the items in most excess were tube feed cartons and gravity bags. The cost of unused supplies per patient was $600.35 post-tracheostomy and $178.31 post-DHT, calculated using the median number of unused items and the item price according to Medex Supply. Percent excess of each tracheostomy item was calculated using the median amount remaining relative to the initial amount received, which revealed that the majority of items go unused. Patients reported challenges in managing and disposing of excess medical supplies, with 42% expressing desire to donate.

Conclusions: This project highlights substantial excess of medical equipment in post-surgical home care, laying the groundwork for interventional strategies, quality improvement initiatives, and donation programs to enhance sustainable practices in otolaryngology.

Presenting Author(s)

Kyle N. Polen, BS

Medical Student
University of Pennsylvania Perelman School of Medicine
Philadelphia, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Caitlin T. Pickeral, PA-C

Otorhinolaryngology Physician Assistant
Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Health System
Philadelphia, PA, United States

Disclosure information not submitted.
Keshav V. Shah, BS

Medical Student
Perelman School of Medicine
Philadelphia, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Steven B. Cannady, MD

Associate Professor
Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
Philadelphia, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
KR

Karthik Rajasekaran, MD

Associate Professor, Head and Neck Oncologic & Reconstructive Surgeon, Director of QI
Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
Philadelphia, PA, United States

Disclosure information not submitted.

Senior Author(s)

Robert M. Brody, MD

Assistant Professor
University of Pennsylvania School of Medicine
Philadelphia, PA, United States

Disclosure information not submitted.