Systematic review of indicators for the assessment of water consumption rates at hospitals

This study reviews the pertinent literature and summarizes water consumption indicators (CI) for hospitals. To facilitate comparison, two consistent metrics are highlighted, namely the annual water usage per bed (m³/bed/year) and per built area (m³/m²/year) for the different locations. Overall, the review reveals a wide variation among water consumption indicators. Hospitals in Italy have a reported use of 458 m³/bed/year, the highest indicator reported; the lowest CI among the reviewed articles was for German public hospitals at 103 m³/bed/year. Not surprisingly, higher water tariffs tend to reduce consumption, while higher per capita income increases consumption. Yet overall CI values tended to reflect a variety of causes, including activity level, laundry arrangements, water costs, the application of sustainable practices, environmental certification and other considerations. Given the high indicator values identified for Brazilian hospitals, future research might consider a more detailed study of how their water consumption might be better managed.