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HEALTH AND SANITATION
Healthcare and plumbing : a necessary and profitable partnership . ( Part 1 )
David Viola , IAPMO CEO
In the spirit of the sharing of unique experiences that shape the plumbing industries in our respective nations , the following article looks at how plumbing ’ s role in preventing waterborne pathogen outbreaks can be a financial boon , while also helping healthcare facilities provide better care . Written by Christoph Lohr , IAPMO ’ s vice president of Strategic Initiatives , it is the next in a regular series of similar articles that will run in this magazine .
“ Data from this study suggests the more HAIs you eliminate and the more capacity you build for the hospital , the higher the total hospital costs will go ”
By
Christoph Lohr
If the Covid crisis has shown us anything , it is that networking has simultaneously become both easier and more difficult .
On one hand , most of us seem to be in perpetual zoom meetings , never getting a chance to get actual work done . On the other hand , we have all learned to get more comfortable with virtual meetings and networking . Many of us have taken advantage of the opportunity to use social media and other electronic means to make new contacts or re-establish old ones . I too took the opportunity to reach out to two old elementary and high school classmates , both medical doctors , to get their perspective on waterborne pathogens ( WBP ). One is an emergency room physician , the other a physician at a children ’ s hospital . Their perspective and stories enlightened me :
• Both of my childhood classmates remembered covering Legionella and other waterborne pathogens in their graduate medical coursework . They both had a general awareness that WBPs come from plumbing fixtures and heated water .
• Both physicians indicated to me that WBPs are typically tested for later in the diagnosis process .
• Both doctors were aware of the Flint water crisis with regards to lead but knew less about the Legionella-related health impacts . This was particularly interesting to me as we all grew up in Michigan together , and both physicians had attended the University of Michigan for their undergraduate studies . We all had a local connection to that story .
Their reaction was interesting , though , when I had the chance to share financial impact studies of WBPs ; their interest was piqued – there was more to investigate in helping healthcare facilities ’ financial performance improve ? The studies that most piqued these physicians ’ interest were as follows : 1 . Tufts University : A team led by researchers from the Friedman School of Nutrition Science and Policy at Tufts University and Tufts University School of Medicine found that between 1991 and 2006 more than 617 000 hospitalisations related to three common plumbing pathogens resulted in around
USD9-billion in Medicare payments — an average of USD600 million a year . The costs may now exceed USD2-billion for 80 000 cases per year , according to the study authors . Antibiotic resistance , which can be exacerbated by ageing public water infrastructure , was present in between 1-2 % of hospitalisations and increased the cost per case by between 10-40 %.
2 . AJIC & Stanford : For each healthcare-associated infection ( HAI ) eliminated , data suggests that a hospital ’ s cost and revenue would increase to USD25 008 and USD1 518 682 , respectively , by backfilling beds with new patients at a 4.62:1 ratio . The reduction of HAIs is profitable for hospitals . Conclusions : Data from this study suggests the more HAIs you eliminate and the more capacity you build for the hospital , the higher the total hospital costs will go . This is an essential shift to the current paradigm that will allow for the accurate and continued funding of HAI reduction programmes . Although hospital cost appears to increase as HAIs are reduced , hospital profits rise even more .
3 . The World Health Organisation lists R & D needs for new antibiotic development to deal with the 12 deadliest pathogens . Ten of the 12 pathogens are waterborne . a . Priority 1 : CRITICAL i . Acinetobacter baumannii , carbapenem-resistant ii . Pseudomonas aeruginosa , carbapenemresistant iii . Enterobacteriaceae , carbapenem-resistant ,
ESBL-producing b . Priority 2 : HIGH i . Enterococcus faecium , vancomycin-resistant ii . Staphylococcus aureus , methicillin-resistant , vancomycin-intermediate , and resistant iii . Helicobacter pylori , clarithromycin-resistant iv . Campylobacter spp ., fluoroquinolone-resistant v . Salmonellae , fluoroquinolone-resistant c . Neisseria gonorrhoeae , cephalosporin-resistant , fluoroquinolone-resistant d . Priority 3 : MEDIUM i . Streptococcus pneumoniae , penicillin-nonsusceptible
www . plumbingafrica . co . za @ plumbingonline @ plumbingonline @ PlumbingAfricaOnline June 2022 Volume 28 I Number 4