de Preux Laure, Rizmie Dheeya
Imperial College Business School, Imperial College London, London, UK.
Future Healthc J. 2018 Jun;5(2):103-107. doi: 10.7861/futurehosp.5-2-103.
The healthcare sector is one of the largest polluters in the UK, accounting for 25% of total emissions of carbon dioxide of the public sector. Ironically, it is the healthcare sector itself that is primarily affected by any deterioration in the environment affecting individuals' health and their demand for healthcare. Therefore, the healthcare sector is a direct beneficiary of its own steps towards sustainability and is more and more viewed as the one who should lead the change. In this article, we first review the concepts of financial and environmental sustainability. Second, we discuss the existing evidence of sustainable changes within this sector. Third, we propose a simple adaptation of the classic cost-effectiveness analysis to incorporate carbon footprinting to account for these external costs. We illustrate our method using the case of in-centre versus home haemodialysis. We conclude that home dialysis is always a preferable alternative to in-centre treatment based on a cost-effectiveness analysis. Finally, we discuss the limitations of our approach and the future research agenda.
医疗保健部门是英国最大的污染源之一，占公共部门二氧化碳总排放量的25%。具有讽刺意味的是，受影响个人健康及其医疗保健需求的环境恶化主要影响的正是医疗保健部门本身。因此，医疗保健部门是其自身迈向可持续发展举措的直接受益者，并且越来越被视为应该引领变革的一方。在本文中，我们首先回顾财务和环境可持续性的概念。其次，我们讨论该部门内可持续变革的现有证据。第三，我们提出对经典成本效益分析进行简单调整，将碳足迹纳入其中以考虑这些外部成本。我们以中心血液透析与家庭血液透析为例来说明我们的方法。我们得出结论，基于成本效益分析，家庭透析始终是比中心治疗更可取的选择。最后，我们讨论我们方法的局限性以及未来的研究议程。
