From Marty: Making the Business Case...
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 It was great seeing the incredible work hospitals in the Well Baby track are engaged in across the state as we continue our drive to increase exclusive human milk rates by 50% in the nursery and we look forward to hearing more from the NCCC track on May 19th!
Several attendees at last week's meetings asked for additional support in making the business case. For perinatal healthcare providers it seems unnecessary to need to make a business case to hospitals to support breastfeeding. We as providers familiar with the literature know well the short and long term benefits for infants, mothers, families and the healthcare system. In a time of constrained resources, however, hospital administrators approached with a multitude of best practices are forced to make difficult decisions. Providing meaningful up front support for best practice initiatives means it is unlikely that all best practice initiatives can be funded. It is difficult to see future return, especially if far in the future, when initial investments are required. What is unique about perinatal initiatives is that the vast majority return on investment (ROI) over the course of a pregnancy or 1-2 years. In addition, the ROI, especially for breastfeeding, lasts a lifetime.
Click here for an article that makes the larger healthcare system case for the value of breastfeeding. There is a clear, calculable ROI that can be attributed to the efforts you are making in your unit. And the ROI is enormous. If we are successful, our efforts will, across North Carolina, will result in medical benefits to moms and babies. The enclosed study does not account for maternal benefits including decreased postpartum bleeding and more rapid uterine involution attributable to increased concentrations of oxytocin, decreased menstrual blood loss, increased child spacing attributable to lactational amenorrhea, earlier return to pre-pregnancy weight, decreased risk of breast cancer, decreased risk of ovarian cancer, and possibly decreased risk of hip fractures and osteoporosis in the postmenopausal period. Savings to the healthcare system for infants and children, in morbidity and mortality, are assessed. This includes reductions in infant mortality, lower respiratory tract infections, otitis media, atopic dermatitis, gastroenteritis, SIDS, diabetes, obesity, leukemia and asthma. The study findings account for annual direct and indirect costs related to pediatric health conditions cited by AHRQ as having a more favorable risk ratio when breastfeeding occurs. These results can be extrapolated to our North Carolina and in hospital initiative. A reasonable proposition is that if EHM increases initiation rates by 50% (17,920 mothers) breastfeeding at 6 months will continue for only 50% (8,960) of those mothers. Excluding costs associated with NEC and deaths, we estimate that $7.3M will be saved annually by this initiative. When 3 infant deaths (SIDS, pneumonia) are included, the total childhood cost savings for EHM Nursery is $39.1M.
Click here for a link to a DHHS Presentation on The Business Case for Breastfeeding. This presentation highlights critical issues in making the "value" case for breastfeeding, particularly as it affects maternal workers. An example is that CIGNA reported in a 2-year study of 343 breastfeeding employees an annual savings of $240,000 in health care expenses, 62 percent fewer prescriptions, and $60,000 in reduced absenteeism rates.
A critical element in this initiative is the work you all do locally to gain acceptance of the value of the EHM work at your facility. While there are unique concerns at all our hospitals, as in all things, this is an opportunity for us to do much together. As you approach the business case and "value" of the EHM initiative at your hospital, please keep us informed of your efforts.
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| Contact |
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Keith M. Cochran
PQCNC Debrouillard
keith_cochran@unc.edu
919.966.8182
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