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癌症患者由门诊就诊转为远程医疗可估算的碳排放量节省。

Estimated Carbon Emissions Savings With Shifts From In-Person Visits to Telemedicine for Patients With Cancer.

机构信息

Department of Head and Neck and Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida.

Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa.

出版信息

JAMA Netw Open. 2023 Jan 3;6(1):e2253788. doi: 10.1001/jamanetworkopen.2022.53788.

Abstract

IMPORTANCE

While the health care community advocates broadly for climate change policy, medical professionals can look within care practices to assess their contribution to carbon dioxide (CO2) emissions, and provide solutions wherever possible. Telemedicine can help in mitigating climate change by providing care from a distance.

OBJECTIVE

To assess the carbon savings achieved from telemedicine visits.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of telemedicine visits was conducted at a single-institution National Cancer Institute (NCI)-designated comprehensive cancer center. Eligible patients were aged 18 years and above, completed telemedicine visits from April 1, 2020, to June 20, 2021, and had a Florida mailing address documented in their electronic medical record. Groups were divided between those within driving time of 60 minutes (1-way) to the cancer center vs those living beyond 60 minutes of drive time. Data were analyzed between April 2020 and June 2021.

MAIN OUTCOMES AND MEASURES

Carbon emission savings from telemedicine, measured in total and average per-visit savings.

RESULTS

A total 49 329 telemedicine visits with 23 228 patients were conducted from April 1, 2020, to June 30, 2021. A total 21 489 visits were for patients with driving time of 60 minutes or less (median [IQR] age, 62.0 [52.0-71.0] years; 12 334 [57.4%] female; 1685 [7.8%] Black, 1500 [7.0%] Hispanic, 16 010 [74.5%] non-Hispanic White), while 27 840 visits were for patients with driving time greater than 60 minutes (median [IQR] age, 67.0 [57.0-74.0] years; 14 372 [51.6%] female; 1056 [3.8%] Black, 1364 [5.0%] Hispanic, 22 457 [80.7%] non-Hispanic White). For patients living within a driving time of 60 minutes from the cancer center, 424 471 kg CO2 emissions were saved (mean [SD] emissions savings, 19.8 [9.4] kg CO2 per visit) due to telemedicine-equivalent to 91.5 passenger vehicles driven for 1 year. For patients whose driving distance was greater than 60 minutes, 2 744 248 kg CO2 emissions were saved (mean emissions savings, 98.6 [54.8] kg CO2 per visit)-equivalent to 591 passenger vehicles driven for 1 year.

CONCLUSIONS AND RELEVANCE

Using a large data set, this cross-sectional analysis highlighted the carbon emissions savings due to telemedicine in oncology. This has important implications in reducing health care-related carbon footprint.

摘要

重要性

虽然医疗保健界广泛倡导气候变化政策,但医学专业人员可以审视医疗实践,评估其对二氧化碳 (CO2) 排放的贡献,并尽可能提供解决方案。远程医疗可以通过远程提供护理来帮助减轻气候变化。

目的

评估远程医疗访问所实现的碳节约。

设计、设置和参与者:这项对远程医疗访问的横断面研究在一家单一机构的美国国家癌症研究所 (NCI) 指定的综合性癌症中心进行。合格的患者年龄在 18 岁及以上,在 2020 年 4 月 1 日至 2021 年 6 月 20 日期间完成远程医疗访问,并且他们的电子病历中有佛罗里达州的邮寄地址记录。根据到癌症中心的单程驾驶时间,将患者分为 60 分钟(单程)以内的组与驾驶时间超过 60 分钟的组。数据分析于 2020 年 4 月至 2021 年 6 月进行。

主要结果和措施

远程医疗的碳减排量,以总排放量和每次访问的平均减排量来衡量。

结果

从 2020 年 4 月 1 日至 2021 年 6 月 30 日,共进行了 49329 次远程医疗访问,涉及 23228 名患者。其中 21489 次访问是针对开车时间在 60 分钟或更短时间的患者(中位数[IQR]年龄,62.0[52.0-71.0]岁;12334[57.4%]为女性;1685[7.8%]为黑人,1500[7.0%]为西班牙裔,16010[74.5%]为非西班牙裔白人),而 27840 次访问是针对开车时间超过 60 分钟的患者(中位数[IQR]年龄,67.0[57.0-74.0]岁;14372[51.6%]为女性;1056[3.8%]为黑人,1364[5.0%]为西班牙裔,22457[80.7%]为非西班牙裔白人)。对于居住在距离癌症中心 60 分钟车程范围内的患者,由于远程医疗等效于 91.5 辆汽车行驶 1 年,因此节省了 424471 千克二氧化碳排放量(平均[SD]减排量,每次就诊 19.8[9.4]千克 CO2)。对于开车距离超过 60 分钟的患者,节省了 2744248 千克二氧化碳排放量(平均减排量,每次就诊 98.6[54.8]千克 CO2)-相当于 591 辆汽车行驶 1 年。

结论和相关性

使用大型数据集,这项横断面分析强调了远程医疗在肿瘤学方面的碳减排效益。这对减少与医疗保健相关的碳足迹具有重要意义。

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