PhD Student, Imperial College Business School, Imperial College London, UK.
J Health Serv Res Policy. 2013 Oct;18(4):209-14. doi: 10.1177/1355819613492717. Epub 2013 Aug 14.
Health services contribute significantly to greenhouse gas emissions. New models of delivering care closer to patients have the potential to reduce travelling and associated emissions. We aimed to compare the emissions of patients attending a teleconsultation - an outpatient appointment using video-conferencing equipment - with those of patients attending a face-to-face appointment.
We estimated the total distances travelled and the direct and indirect greenhouse gas emissions for 20,824 teleconsultations performed between 2004 and 2011 in Alentejo, a Portuguese region. These were compared to the distances and emissions that would have resulted if teleconsultations were not available and patients had to attend face-to-face outpatient appointments. Estimates were calculated using survey data on mode of transport, and national aggregate data for car engine size and fuel. A sensitivity analysis using the lower and upper quartiles for survey distances was performed.
Teleconsultations led to reductions in distances and emissions of 95%. 2,313,819 km of travelling and 455 tonnes of greenhouse gas emissions were avoided (22 kg of carbon dioxide equivalent per patient). The incorporation of modes of transport and car engine size and fuel in the analysis led to emission estimates which were 12% smaller than those assuming all patients used an average car.
The availability of remote care services can significantly reduce road travel and associated emissions. At a time when many countries are committed to reducing their carbon footprint, it is desirable to explore how these reductions could be incorporated into technology assessments and economic evaluations.
卫生服务对温室气体排放有重大影响。为患者提供更接近患者的新护理模式有减少旅行和相关排放的潜力。我们旨在比较通过视频会议设备进行的远程咨询(门诊预约)的患者的排放量与面对面就诊的患者的排放量。
我们估计了 2004 年至 2011 年间在葡萄牙阿连特茹地区进行的 20824 次远程咨询的总旅行距离以及直接和间接温室气体排放量。将这些与如果没有远程咨询并且患者必须进行面对面门诊预约则会产生的距离和排放量进行了比较。使用有关运输方式的调查数据以及有关汽车发动机排量和燃料的国家综合数据计算了估计值。使用调查距离的较低和较高四分位数进行了敏感性分析。
远程咨询导致旅行距离和排放量减少了 95%。避免了 2313819 公里的旅行和 455 吨的温室气体排放(每位患者 22 公斤二氧化碳当量)。在分析中纳入了运输方式以及汽车发动机排量和燃料,这导致排放量的估计值比假设所有患者都使用平均汽车的估计值小 12%。
远程护理服务的提供可以大大减少道路旅行和相关排放。在许多国家都致力于减少碳足迹的时候,有必要探讨如何将这些减排措施纳入技术评估和经济评估中。