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气候变化缓解:德国初级保健中减少环境影响策略的定性分析。

Climate change mitigation: Qualitative analysis of environmental impact-reducing strategies in German primary care.

机构信息

Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Eur J Gen Pract. 2023 Dec;29(1):2232946. doi: 10.1080/13814788.2023.2232946.

Abstract

BACKGROUND

The German healthcare system is responsible for 5,2% of the national emissions of greenhouse gases. Therefore, mitigation actions to reduce the carbon footprint are crucial. However, there have been few approaches to achieve this in German primary care.

OBJECTIVES

This study aimed to identify environmental impact-reducing strategies of German primary care practices.

METHODS

During the summer of 2021, a qualitative study was conducted using interviews and focus groups with experts in primary care across Germany, such as physicians, medical assistants, health scientists and experts on the health system level. Verbatim transcribed data were analyzed using Thematic Analysis.

RESULTS

The sample comprised 26 individual interviews and two focus groups with a total of  = 40 participants. Findings provide a first overview of pursued and influencing their implementation. Strategies referred to the use of water and energy, recycling and waste management, supply chains and procurement, digitisation, mobility, patient care, behavioural changes and system level. Implementing sustainable actions in daily care was considered expensive and often unfeasible due to lack of staff, time and restrictive hygiene regulations. Participants called for more instruction on implementing mitigating actions, for example, through websites, podcasts, guidelines or quality indicators.

CONCLUSION

This study's findings can support the development of future environmental impact-reducing strategies in primary care. Potential options for guidance and support should be considered to facilitate sustainability.

摘要

背景

德国的医疗保健系统负责全国温室气体排放量的 5.2%。因此,减少碳足迹的缓解措施至关重要。然而,德国初级保健中很少有方法可以实现这一目标。

目的

本研究旨在确定德国初级保健实践中减少环境影响的策略。

方法

在 2021 年夏天,使用德国各地初级保健专家(如医生、医疗助理、卫生科学家和卫生系统专家)的访谈和焦点小组进行了一项定性研究。使用主题分析对逐字转录的数据进行了分析。

结果

样本包括 26 次个人访谈和 2 次焦点小组,共有 40 名参与者。研究结果提供了已实施和影响其实施的策略的初步概述。策略涉及水和能源的使用、回收和废物管理、供应链和采购、数字化、流动性、患者护理、行为改变和系统层面。由于缺乏人员、时间和限制性的卫生法规,参与者认为在日常护理中实施可持续行动既昂贵又常常不可行。他们呼吁提供更多关于实施缓解措施的指导,例如通过网站、播客、指南或质量指标。

结论

本研究的结果可以为初级保健中未来减少环境影响的策略的制定提供支持。应考虑潜在的指导和支持选项,以促进可持续性。

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