Newly developed risk chart identifies the hidden costs of health care during power failures

Author: Deanna Csomo McCool

A team headed by a University of Notre Dame researcher delved into the hidden costs of electrical failures in hospital settings and has created a new model, which can be used by countries around the world, for determining the probability of deaths based on the likelihood of electrical failure.

Mechtenberg

The model, co-developed by Abigail Mechtenberg, assistant teaching professor in the Department of Physics who is affiliated with Notre Dame’s Center for Sustainable Energy, culminated in the creation of a new energy healthcare system (EHS) risk chart, according to the study published in the journal PLOS ONE

Many countries have weaker electrical grids than in the United States, and utility companies have to “load shed,” or cut down power in a region at different times of the day, to prevent straining the grid and causing a mass power outage. Depending on the systems used in different countries, the price per kilowatt hour to run another backup energy system on-site may be considerably lower than the cost associated with the patient risk or death, Mechtenberg noted.

“The risk chart will help us figure out the overall utility and allow us to consider new energy and global health policy implications to adapt,” she said.

To develop the model, Mechtenberg led an international team that looked at four types of energy failure patterns in four countries - Iraq, Ghana, Bangladesh, and Uganda. For instance, previously published research suggested an Iraqi healthcare energy system relied on solar-only power in their hospital setting, while a Ugandan regional hospital used grid and backup diesel power for higher power surgeries, and solar for lighting. The team analyzed many research results, focusing on four key statistical energy failure pattern types demonstrated by the years’ worth of hour-by-hour energy failures.

They also looked at surgeries per 100,000 people and compared it with average electrical power consumed, as well as life expectancy at birth in each country. By dividing this by the population, they developed a unit of “watts per person.” The study showed that the statistical value of lives lost (VSL) divided by energy shortage during the failure was 10 to 10,000 times the cost of the electricity alone for those four regions. And there were between 3 and 105 deaths per 1,000 patients, depending on the energy failure pattern and medical procedure impact groups, regardless of country considered.

“A human being, on a bicycle generator, can generate 100 watts of electricity,” she said, noting that 100 watts is the amount of one light bulb. In some countries, consuming that additional 100 watts per capita could bring down the electrical grid. 

But surgeries and procedures need to happen, and administrators need a way to determine the additional risk of performing them.The newly developed method gives energy experts and health care experts a quantifiable way to make decisions together by discussing what to do during “load shedding” or on-site power outages while considering the “backup to the backup” energy and medical system options. Often it was assumed that the energy shortage would occur at night, but this team’s research indicates that’s not always the case.

Mechtenberg recalls one example from her thesis that spotlights the problem. She was in the children’s ward of a hospital collecting power load data for all the appliances in the hospital when she got to know a mother, her child, and a nurse. The boy was on an oxygen concentrator to help him breathe.

But the next morning, she saw the mother in the morgue, mourning her child’s death.

“I asked the nurse what happened and she said during the night the hospital experiences load shedding and said they couldn’t run a generator just to power a couple of oxygen concentrators because it is too expensive and the solar panel system installed by a donor could only power lighting,” Mechtenberg said. “So I looked at how much power is needed for an oxygen concentrator, and it’s at the level of human power.”

Or, in that electricity failure event, potentially just a little more than a light bulb. “And I realized these are avoidable events.”

 

Originally published by Deanna Csomo McCool at science.nd.edu on November 20, 2020.