Desenzi Ciaralo Pedro Prosperi, Guerreiro Cardoso Paulo Francisco, Minamoto Helio, Bibas Benoit Jacques, Ribeiro de Carvalho Carlos Roberto, Pego-Fernandes Paulo Manuel
Division of Thoracic Surgery, Instituto do Coracao do Hospital das Clinicas HCFMUSP da Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
Division of Thoracic Surgery, Instituto do Coracao do Hospital das Clinicas HCFMUSP da Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
Int J Med Inform. 2025 Mar;195:105757. doi: 10.1016/j.ijmedinf.2024.105757. Epub 2024 Dec 7.
The patient's journey to the medical center for an outpatient visit can often mean hours of travel in their vehicle, leading to increased expenses and greater carbon dioxide (CO2) emissions into the environment. The study demonstrates the estimated carbon emission and cost savings associated with a telemedicine program dedicated to patients with tracheal disease in the Brazilian public health system.
Cross-sectional study of telemedicine visits for patients with tracheal disease referred to a public academic hospital between August 1, 2020, and December 30, 2023. The consultations occurred in a telemedicine department using the hospital's proprietary platform. The analysis included the round-trip distance savings using home postal codes; CO2 emissions savings by transportation using the Greenhouse Gas Protocol (GHG Protocol) adapted to the Brazilian reality ("Programa Brasileiro GHG Protocol"); and the cost savings in transportation and support using the Brazil Ministry of Health program.
1767 telemedicine visits with 680 patients were conducted, 363 (53.4 %) male and 317 (46.6 %) female, a median [IQR] age of 33 [12.0-51.0] years. Patients were from 170 Brazilian cities from 22 states. There were 2.219.544,3 round-trip kilometers saved (median per patient [IQR] 542,88km [190,36-2.672,6]), corresponding to an estimated 353.097,55kg of CO2 emissions savings (median per patient [IQR] 102,56kg [36,56-496,96]). The cost savings was 305.187,96 dollars (median per patient [IQR] $48,22 [24,97-162,51] dollars).
Telemedicine consultations, in addition to significantly reducing carbon emissions and costs, promote greater accessibility and sustainability in medical care. These findings may influence public policies to expand telemedicine programs, especially in remote regions, and strengthen environmental initiatives in healthcare.
患者前往医疗中心进行门诊就诊，往往意味着要在车内花费数小时，这会导致费用增加，并向环境中排放更多的二氧化碳（CO₂）。本研究展示了巴西公共卫生系统中一项针对气管疾病患者的远程医疗项目所带来的估计碳排放和成本节约情况。
对2020年8月1日至2023年12月30日期间转诊至一家公立学术医院的气管疾病患者的远程医疗就诊情况进行横断面研究。会诊在远程医疗部门使用医院的专有平台进行。分析内容包括利用家庭邮政编码节省的往返距离；根据适用于巴西实际情况的《温室气体议定书》（“巴西温室气体议定书”）计算的交通碳排放节省量；以及利用巴西卫生部项目在交通和支持方面的成本节省情况。
对680名患者进行了1767次远程医疗会诊，其中男性363名（53.4%），女性317名（46.6%），年龄中位数[四分位间距]为33[12.0 - 51.0]岁。患者来自巴西22个州的170个城市。共节省了2219544.3公里的往返路程（每位患者中位数[四分位间距]为542.88公里[190.36 - 2672.6]），估计节省了353097.55千克的二氧化碳排放量（每位患者中位数[四分位间距]为102.56千克[36.56 - 496.96]）。成本节省为305187.96美元（每位患者中位数[四分位间距]为48.22美元[24.97 - 162.51]美元）。
远程医疗会诊除了能显著减少碳排放和成本外，还能提高医疗服务的可及性和可持续性。这些研究结果可能会影响公共政策，以扩大远程医疗项目，特别是在偏远地区，并加强医疗保健领域的环境倡议。
