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Applied health economics and health policy
Mar, 2025;23 (2): 265-275.

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

Paul-Simon Pugliesi, Hervé Frick, Stéphanie Guillot, Karine Ferrare, Catherine Renzullo, Alexandre Benoist, Serge Ribes, Guillaume Beltramo, Thomas Maldiney, Romain Ter Schiphorst, Caroline Abdul Malak, Adrien Bevand, Laurie Marrauld, Catherine Lejeune
Author Information
  1. Paul-Simon Pugliesi: Department of Intensive Care, William Morey Hospital, Chalon sur Saône, France. PaulSimon.Pugliesi@ch-chalon71.fr. ORCID
  2. Hervé Frick: Department of Sustainable Development, William Morey Hospital, Chalon sur Saône, France.
  3. Stéphanie Guillot: Department of Anesthesia and Operating Rooms, William Morey Hospital, Chalon sur Saône, France.
  4. Karine Ferrare: Department of Anesthesia and Operating Rooms, William Morey Hospital, Chalon sur Saône, France.
  5. Catherine Renzullo: Pharmacy, William Morey Hospital, Chalon sur Saône, France.
  6. Alexandre Benoist: Dept of Biomedical Engineering, William Morey Hospital, Chalon sur Saône, France.
  7. Serge Ribes: Department of Sustainable Development, William Morey Hospital, Chalon sur Saône, France.
  8. Guillaume Beltramo: INSERM U1231, Dijon, France.
  9. Thomas Maldiney: Department of Intensive Care, William Morey Hospital, Chalon sur Saône, France.
  10. Romain Ter Schiphorst: Department of Intensive Care, William Morey Hospital, Chalon sur Saône, France.
  11. Caroline Abdul Malak: Department of Intensive Care, William Morey Hospital, Chalon sur Saône, France.
  12. Adrien Bevand: Dept of Orthopedic and Traumatological Surgery, William Morey Hospital, Chalon sur Saône, France.
  13. Laurie Marrauld: University of Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Health Services and Management Research) - U 1309, 35000, Rennes, France.
  14. Catherine Lejeune: CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, 7 bd Jeanne d'Arc, BP 87900, 21000, Dijon, France.
PMID: 39738920 DOI: 10.1007/s40258-024-00933-w

Abstract

BACKGROUND: Economic evaluation aims to compare the costs and results of health strategies to inform public decision making. Although sometimes suggested, until now no national evaluation agency has recommended formally incorporating the cost of greenhouse gas (GHG) emissions generated by health interventions into the estimation of healthcare costs.
OBJECTIVE: The objective of this study was to test and discuss the feasibility of estimating and including the contribution of GHG emissions cost to the total cost of a surgical intervention, with the example of robot-assisted total knee arthroplasty (RTA), using a micro-costing approach.
METHODS: The study was conducted in June 2022 at the William Morey Hospital (France). Data regarding all of the resources (labor, medical equipment, consumables), as well as energy consumption, staff commuting and waste treatment were collected and valued from the hospital point of view. Greenhouse gas emissions were valued using a cost-effectiveness approach. Several sensitivity analyses were performed.
RESULTS: The mean cost per patient of an RTA was estimated to be €4755.65, of which €152.64 (3.21 %) would be attributable to GHG emissions. The contribution of GHG emissions in the overall cost of a health intervention was highly dependent on the convention used for the price of carbon.
CONCLUSION: Despite persistent theoretical and practical challenges, adding the estimation of GHG emission costs in the economic evaluation of health interventions may provide institutional decision makers with information that allows them to allocate the public healthcare resources more efficiently.

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MeSH Term

Humans
France
Greenhouse Gases
Cost-Benefit Analysis
Arthroplasty, Replacement, Knee
Health Care Costs
Greenhouse Effect

Chemicals

Greenhouse Gases
Journal Article

Word Cloud

Created with Highcharts 10.0.0costGHGemissionshealthevaluationcostspublicdecisiongasinterventionsestimationhealthcarestudycontributiontotalinterventionRTAusingapproachresourcesvaluedCostBACKGROUND:EconomicaimscompareresultsstrategiesinformmakingAlthoughsometimessuggestednownationalagencyrecommendedformallyincorporatinggreenhousegeneratedOBJECTIVE:objectivetestdiscussfeasibilityestimatingincludingsurgicalexamplerobot-assistedkneearthroplastymicro-costingMETHODS:conductedJune2022WilliamMoreyHospitalFranceDataregardinglabormedicalequipmentconsumableswellenergyconsumptionstaffcommutingwastetreatmentcollectedhospitalpointviewGreenhousecost-effectivenessSeveralsensitivityanalysesperformedRESULTS:meanperpatientestimated€475565€15264321%attributableoverallhighlydependentconventionusedpricecarbonCONCLUSION:DespitepersistenttheoreticalpracticalchallengesaddingemissioneconomicmayprovideinstitutionalmakersinformationallowsallocateefficientlyCarbonTotalHealthcareProcedure:ExampleMicro-CostingStudyFrenchSetting

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