Health care during electricity failure: The hidden costs

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Health care during electricity failure: The hidden costs



JournalPLOS One
Article typeJournal research article – Clinical research
Publication date – Nov – 2020
Authors – Abigail Mechtenberg, Brady McLaughlin, Michael DiGaetano, Abigail Awodele, Leslie Omeeboh, Emmanuel Etwalu, Lydia Nanjula, Moses Musaazi, Mark Shrime
KeywordsAlternative energy, Charts, Electricity, Health care facilities, Medical devices and equipment, Medical personnel, Medical risk factors, Surgical and invasive medical procedures
Open access – Yes
SpecialityHealth policy, Other
World region Global

Language – English
Submitted to the One Surgery Index on November 26, 2020 at 8:19 pm
Abstract:

Background
Surgery risks increase when electricity is accessible but unreliable. During unreliable electricity events and without data on increased risk to patients, medical professionals base their decisions on anecdotal experience. Decisions should be made based on a cost-benefit analysis, but no methodology exists to quantify these risks, the associated hidden costs, nor risk charts to compare alternatives.

Methods
Two methodologies were created to quantify these hidden costs. In the first methodology through research literature and/or measurements, the authors obtained and analyzed a year’s worth of hour-by-hour energy failures for four energy healthcare system (EHS) types in four regions (SolarPV in Iraq, Hydroelectric in Ghana, SolarPV+Wind in Bangladesh, and Grid+Diesel in Uganda). In the second methodology, additional patient risks were calculated according to time and duration of electricity failure and medical procedure impact type. Combining these methodologies, the cost from the Value of Statistical Lives lost divided by Energy shortage ($/kWh) is calculated for EHS type and region specifically. The authors define hidden costs due to electricity failure as VSL/E ($/kWh) and compare this to traditional electricity costs (always defined in $/kWh units), including Levelized Cost of Electricity (LCOE also in $/kWh). This is quantified into a fundamentally new energy healthcare system risk chart (EHS-Risk Chart) based on severity of event (probability of deaths) and likelihood of event (probability of electricity failure).

Results
VSL/E costs were found to be 10 to 10,000 times traditional electricity costs (electric utility or LCOE based). The single power source EHS types have higher risks than hybridized EHS types (especially as power loads increase over time), but all EHS types have additional risks to patients due to electricity failure (between 3 to 105 deaths per 1,000 patients).

Conclusions
These electricity failure risks and hidden healthcare costs can now be calculated and charted to make medical decisions based on a risk chart instead of anecdotal experience. This risk chart connects public health and electricity failure using this adaptable, scalable, and verifiable model.

OSI Number – 20779

Public annotations on this article:

This paper has seven main topics and we have included a video annotation and discussion for each part as well as a playlist of all the 5-10 minute videos:

These include implications of research as well first author introduction. There is also a discussion about humans rights in terms of avoidable unmet power loads in hospitals and health care facilities as well as discussion about our previous paper asking interesting ethical dilemmas surgeons face and comparing energy options available and not currently discussed.

(1) Research Introduction to Energy Healthcare System (EHS)

(2) Part A – Yearly Electricity Failure Patterns Methodology and Results

(3) Part B – Additional Patient Risk due to Electricity Failure Methodology

(4) Part C – Site Specific Statistics Methodology

(5) EHS Risk Chart with Severity and Likelihood in either units of Days Experiencing Risk Category, Deaths, and Hidden Costs (VSL/E) Methodology and Results

(6) Implications and Evaluating Hospital Claims of deaths due solely to electricity failure – Evaluated Jinja Regional Hospital doctors’ claim that 150 patient deaths occurred solely due to power failure and people questioned scientifically collected data

(7) Discussion that Model is Adaptable, Scalable and Verifiable and Specific Implementable Recommendations

Abigail Mechtenberg – Other, United States
December 20, 2020 at 6:10 am