Department of Family Medicine, Michael G DeGroote School of Medicine, Hamilton, ON, Canada.
Department of Child and Youth Studies, Brock University, St Catherine's, ON, Canada.
Lancet Planet Health. 2024 May;8(5):e327-e333. doi: 10.1016/S2542-5196(24)00048-2.
Health care contributes 4·4% of global net carbon emissions. Hospitals are resource-intensive settings, using a large amount of supplies in patient care and have high energy, ventilation, and heating needs. This Viewpoint investigates emissions related to health care in a patient's last year of life. End of life (EOL) is a period when health-care use and associated emissions production increases exponentially due primarily to hospital admissions, which are often at odds with patients' values and preferences. Potential solutions detailed within this Viewpoint are facilitating advanced care plans with patients to ensure their EOL wishes are clear, beginning palliative care interventions earlier when treating a life-limiting illness, deprescribing unnecessary medications because medications and their supply chains make up a significant portion of health-care emissions, and, enhancing access to low-intensity community care settings (eg, hospices) within the last year of life if home care is not available. Our analysis was done using Canadian data, but the findings can be applied to other high-income countries.
医疗保健占全球净碳排放的 4.4%。医院是资源密集型场所，在患者护理中大量使用物资，并具有较高的能源、通风和供暖需求。本观点探讨了与患者生命最后一年相关的医疗保健排放。生命末期（EOL）是医疗保健使用和相关排放产生呈指数级增长的时期，主要原因是住院治疗，这往往与患者的价值观和偏好不符。本观点中详细介绍了一些潜在的解决方案，包括与患者共同制定先进的护理计划，以确保他们的 EOL 意愿明确；在治疗危及生命的疾病时更早地开始姑息治疗干预；减少不必要的药物，因为药物及其供应链占医疗保健排放的很大一部分；并在生命的最后一年，如果无法提供家庭护理，则增加获得低强度社区护理环境（如临终关怀院）的机会。我们的分析使用了加拿大的数据，但这些发现可以应用于其他高收入国家。
