Dental Public Health, NHS Fife, Cameron Hospital, Windygates KY8 5RG, UK.
European Centre for Environment and Human Health, University of Exeter Medical School, Truro Campus, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UK.
Public Health. 2014 Oct;128(10):920-4. doi: 10.1016/j.puhe.2014.08.008. Epub 2014 Oct 7.
Health services must provide safe, affordable clinical care whilst meeting efficiency, environmental and social targets. These targets include achieving reduced greenhouse gas emissions. A care pathway approach based on a decision-support tool can simultaneously reconfigure health services, improve productivity and reduce carbon emissions.
Probabilistic modelling using secondary data analysis.
Estimates of carbon emitted by a health service drew on a previous carbon accounting study which integrated bottom-up assessment of carbon emissions with top-down analysis of indirect emissions by Duane et al. (2012).(1) Using human resource information, estimates were applied in a decision-support model to measure the carbon footprint and service provision of theoretical scenarios. Using this model, sites with less than 60% utilisation were theoretically reconfigured to reduce carbon emissions and improve service provision.
Clinic utilisation rates improved from 50% to 78%. Human resource savings were identified which could be re-directed towards improving patient care. Patient travel for health care was halved resulting in significant savings in carbon emissions.
The proposed model is an effective health care service analysis tool, ensuring optimal utilisation of health care sites and human resources with the lowest carbon footprint.
医疗服务必须在满足效率、环境和社会目标的同时提供安全、经济的临床护理。这些目标包括减少温室气体排放。基于决策支持工具的护理路径方法可以同时重新配置医疗服务，提高生产力并减少碳排放。
使用二次数据分析进行概率建模。
卫生服务产生的碳排放量估算借鉴了 Duane 等人（2012 年）的先前碳核算研究，该研究将碳排放的自下而上评估与间接排放的自上而下分析相结合。（1）使用人力资源信息，将估算值应用于决策支持模型，以衡量理论方案的碳足迹和服务提供情况。使用该模型，理论上将利用率低于 60%的站点进行重新配置，以减少碳排放并改善服务提供。
诊所利用率从 50%提高到 78%。确定了人力资源节约，可以重新用于改善患者护理。患者就医旅行减少了一半，从而大大节省了碳排放。
拟议的模型是一种有效的医疗保健服务分析工具，可确保以最低的碳足迹实现医疗保健场所和人力资源的最佳利用。
