White coats: How long should doctors wear them?

Objectives

Medical While coat contamination increases progressively with the duration of use, there are no guidelines on how frequently medical white coats should be changed. The purpose of our study was to examine the turnover of individual batch of medical white coats in a university hospital.

Study design and methods

A retrospective analysis of the white coat turnover of 826 physicians was performed by using the hospital laundry computerized database and an electronic declarative survey (240 responses) to evaluate the duration of medical white coat use.

Results

There was a wide discrepancy between the data extracted from the laundry database and those from the survey. The median factual duration of use (20 days, range: 15–30) corresponding to a turnover of 2 (1–2) coats per month, was widely underestimated by the physicians. Multivariate analysis identified 4 independent factors associated with a declared use of coats longer than 7 days: estimation of insufficient gown turnover,daily change considered as not useful,non-medical specialtyand presence of stains on gowns.

Hospital Supply Expenses: An Important Ingredient in Health Services Research

The purpose of this article is to shed light on hospital supplies expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician-hospital arrangements, and value-based purchasing.