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医疗程序总成本中的碳成本:一个方法论挑战。

Cost of Carbon in the Total Cost of Healthcare Procedures: A Methodological Challenge.

机构信息

Department of Sustainable development, William Morey Hospital, Chalon sur Saône, France.

Department of Intensive care, William Morey hospital, Chalon sur Saône, France.

出版信息

Appl Health Econ Health Policy. 2024 Sep;22(5):599-607. doi: 10.1007/s40258-024-00890-4. Epub 2024 Jun 11.


DOI:10.1007/s40258-024-00890-4
PMID:38862769
Abstract

Economic evaluations aim to compare the costs and the results of health strategies to guide the public decision-making process. Cost estimation is, thus, a cornerstone of this approach. At present, few national evaluation agencies recommend incorporating the cost of greenhouse gas (GHG) emissions from healthcare actions into the calculation of healthcare costs. Our main goal is to describe and discuss the methodology for integrating the cost of GHG emissions into the field of applied economic evaluations. To estimate this cost, three steps are required: (1) identifying and quantifying the physical flows linked to the production and management of the outputs of healthcare interventions, (2) estimating the quantity of GHG that can be attributed to each physical flow, and (3) valuing these GHG emissions in monetary terms. Integrating the cost of GHG emissions into the calculation of the costs of healthcare interventions is both useful and relevant from a perspective of collective intergenerational well-being. This approach has been made possible thanks to the existence of accounting and monetary valuation methods for emissions. Agencies specialized in health economic evaluations could take up this issue to resolve ongoing questions, thus providing researchers with a methodological framework and public decision-makers with some key insights.

摘要

经济评估旨在比较卫生策略的成本和结果,以指导公共决策过程。因此,成本估算 是该方法的基石。目前,很少有国家评估机构建议将医疗保健行动产生的温室气体 (GHG) 排放成本纳入医疗保健成本的计算中。我们的主要目标是描述和讨论将 GHG 排放成本纳入应用经济评估领域的方法。要估算这一成本,需要三个步骤:(1) 确定和量化与医疗保健干预措施产出的生产和管理相关的物理流;(2) 估算可归因于每个物理流的 GHG 数量;(3) 用货币价值衡量这些 GHG 排放。从集体代际福利的角度来看,将 GHG 排放成本纳入医疗保健干预成本的计算中既有用又相关。由于存在排放的核算和货币估值方法,这一方法成为可能。专门从事健康经济评估的机构可以解决这一问题,从而为研究人员提供一个方法论框架,并为公共决策者提供一些关键的见解。

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引用本文的文献

[1]
Healthcare Costs and Carbon Emissions of Stage III Melanoma Surveillance Imaging.

Appl Health Econ Health Policy. 2025-8-30

[2]
Cost of Carbon in the Total Cost of a Healthcare Procedure: Example of Micro-Costing Study in a French Setting.

Appl Health Econ Health Policy. 2025-3

本文引用的文献

[1]
How environmental impact is considered in economic evaluations of critical care: a scoping review.

Intensive Care Med. 2024-1

[2]
Inclusion of Environmental Spillovers in Applied Economic Evaluations of Healthcare Products.

Value Health. 2023-8

[3]
Implications of anomalous relative sea-level rise for the peopling of Remote Oceania.

Proc Natl Acad Sci U S A. 2022-12-27

[4]
Comprehensive evidence implies a higher social cost of CO.

Nature. 2022-10

[5]
Impact of choice of inhalers for asthma care on global carbon footprint and societal costs: a long-term economic evaluation.

J Med Econ. 2022

[6]
Estimates of economic and environmental damages from tipping points cannot be reconciled with the scientific literature.

Proc Natl Acad Sci U S A. 2022-5-24

[7]
An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare: Key Features, Uses, and Limitations.

Front Public Health. 2021

[8]
Health care's response to climate change: a carbon footprint assessment of the NHS in England.

Lancet Planet Health. 2021-2

[9]
The environmental footprint of health care: a global assessment.

Lancet Planet Health. 2020-7

[10]
A general framework for classifying costing methods for economic evaluation of health care.

Eur J Health Econ. 2020-6

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