Introduction
Hospital-acquired infections (HAIs) are a common occurrence, affecting countless patients worldwide. In Mexico, these infections pose a significant challenge, often complicating routine surgeries and prolonging hospital stays. Moreover, HAIs lead to increased antibiotic usage, heightened bacterial resistance risks, and, in severe cases, mortality. This article delves into the importance of investing in infection prevention within Mexican hospitals, both public and private.
The Scope of the Problem
According to data presented at the V Foro El Desafío de las Infecciones Intrahospitalarias (The Challenge of Hospital-Acquired Infections), over 70% of hospitalized patients require invasive devices such as catheters or respirators, drastically increasing their risk of contracting pathogens. These infections, known as Infecciones Asociadas a la Atención de la Salud (IAAS), affect 1 in every 5 patients, with a mortality rate of 10%. IAAS rank among the top four causes of death in Mexico.
The Economic Argument for Prevention
Given the strain on healthcare resources and the growing burden of chronic diseases, hospital administrators, medical professionals, and decision-makers often question the necessity of investing in prevention when budgets are already stretched thin. However, scientific and economic evidence supports that infection prevention is a strategic investment with multiplied returns.
Benefits of Infection Prevention
- Saving Lives: Preventing infections saves lives by avoiding complications and unnecessary deaths.
- Optimizing Operations: Infection prevention leads to more efficient hospital operations.
- Reducing Costs: By minimizing infection-related expenses, hospitals can lower overall costs.
- Improving Quality of Care: Infection prevention enhances the quality of care, making it a cornerstone for sustainability.
Case Studies: Public and Private Hospitals
At the forum organized by Hospitales sin Infecciones, an NGO initiative, experts explained the economic rationale behind infection prevention. These infections cost Mexican hospitals between 28 billion and 32 billion pesos annually. Each case results in extended hospital stays, increased resource consumption, and a strain on patients’ families.
Private Hospitals
Dr. Octavio González Chon, general director of Médica Sur, emphasized that preventing infections is an investment, not an expense. He quantified this investment and highlighted that the returns are five times greater than the initial investment. Practically, implementing prospective surveillance systems, hygiene protocols (handwashing and instrument sterilization), and staff training allows hospitals to recover this investment by treating more patients with existing resources, reducing legal demands, and enhancing institutional reputation.
Public Hospitals
In underfunded public hospitals, the equation becomes even more compelling. Dr. Alfredo Merino Tapia, former director of Hospital “20 de Noviembre,” argued that what’s needed are quality processes rather than additional funds. He explained that with the same human resources, hospitals can serve more patients through early discharges, efficient patient flows, and adherence to regulations (e.g., quirófano and intensive care unit locations). Demonstrating responsible budget usage through low infection rates could unlock more funds or prevent cuts.
Collective Call to Action
Prominent figures like Dr. María Enriqueta Baridó Murguía (former AMEIN president) and Dr. José Ignacio Santos Preciado (Conacem president) emphasized that hospitals free of infections should be a global aspiration. Without concrete initiatives, hospitals will face ineffective antibiotics, untreatable infections, and unsustainable costs. Prioritizing prevention through rational antibiotic use guidelines, pharmacotherapy committees, and education would be the optimal pathway, fostering sustainable alliances and strategies.
Additional Context: Supply Chain Issues in Mexican Healthcare
Mexico’s health authorities continue to grapple with medication procurement, failing to resolve a persistent seven-year shortage affecting patients. Experts in distribution suggest that the bottleneck originates from poor planning: supplying authorities must provide timely product key data, quantities, and delivery schedules. Meanwhile, receiving units need properly regulated, adequately sized storage facilities.
Key Recommendations
- Involve Cofepris: Engage the Federal Commission for Protection against Sanitary Risks (Cofepris) in the selection of bidders, verifying competitors and valid sanitary registrations to ensure quality medications.
- Prioritize Regulated Companies: Prioritize bids from regulated companies, avoiding allocations to unlicensed or unauthorized distributors presenting only foreign lab letters.
- Demand Compliance Documentation: Require distributors to provide proof of regulatory compliance from national and transnational labs to prevent delivery and quality failures.
- Collaborative Approach: A collaborative and transparent approach would unlock the system, though it remains lacking.
