Medical Physics Service, Portuguese Oncology Institute of Porto, Porto, Portugal.
Department of Health Systems Management and Leadership, Faculty of Health Sciences, University of Malta, Msida, Malta.
Int J Health Policy Manag. 2023;12:6947. doi: 10.34172/ijhpm.2023.6947. Epub 2023 Jun 6.
Circular economy (CE) has raised great interest as a concept and as a development model worldwide. This concept aims to provide a substitute for the linear economic model, which was based on production and consumption, continuous growth, and resources depletion. CE allows a greener economy with sustainable development and promotes more balanced societies. The healthcare sector is a major contributor to the climate crisis, with a carbon footprint representing 4.4% of global net emissions. It is thus essential to rethink the applicability of CE in healthcare.
We conducted a scoping review guided by the Arksey and O'Malley methodological framework and utilised PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist. A systematic search from MEDLINE complete, SCOPUS, and Web of Science databases published between 1992 and 2022.
Through database searching a total of 1018 records were identified and 475 duplicates were removed. From the total search, 543 articles were screened by title/abstract according to the inclusion and exclusion criteria. After screening, 38 full-text articles were selected and assessed for eligibility. Forty-seven additional records were also identified through other sources and screened for eligibility. Other sources included: 12 articles from snowballing of previous papers; 9 articles following peer-reviewers suggestions; 19 reports from relevant organisations in CE and healthcare; two webpage, and one book.
Specific areas were identified where hospitals could reduce their greenhouse gas (GHG) emissions and consequently their negative environmental impact, namely through waste management, energy, water, transportation/travel, hospital design, food optimisation, green procurement, and behaviour. Also, lack of staff awareness and knowledge of the environmental impact of healthcare, and hospitals sustainability were identified as major contributors.
循环经济(CE)作为一个概念和发展模式在全球范围内引起了极大的兴趣。这一概念旨在为基于生产和消费、持续增长和资源枯竭的线性经济模式提供替代方案。CE 允许建立一个更加绿色的经济,实现可持续发展,并促进更加平衡的社会。医疗保健部门是导致气候危机的主要因素之一,其碳足迹占全球净排放量的 4.4%。因此,有必要重新思考 CE 在医疗保健中的适用性。
我们根据 Arksey 和 O'Malley 的方法论框架进行了范围综述,并使用了 PRISMA-ScR(系统评价和荟萃分析扩展的首选报告项目用于范围综述)清单。对 MEDLINE complete、SCOPUS 和 Web of Science 数据库进行了系统搜索,检索时间范围为 1992 年至 2022 年。
通过数据库搜索,共确定了 1018 条记录,并去除了 475 条重复记录。在总搜索中,根据纳入和排除标准,通过标题/摘要筛选了 543 篇文章。筛选后,选择了 38 篇全文文章进行资格评估。还通过其他来源确定了另外 47 条记录,并进行了资格筛选。其他来源包括:12 篇来自先前论文的滚雪球文献;9 篇来自同行评审员的建议;19 篇来自 CE 和医疗保健相关组织的报告;2 个网页和 1 本书。
确定了医院可以减少温室气体(GHG)排放并因此减少其对环境的负面影响的具体领域,方法是通过废物管理、能源、水、交通/旅行、医院设计、食品优化、绿色采购和行为。此外,还发现医院缺乏对医疗保健环境影响的认识和了解以及医院的可持续性是主要因素。