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Carrandi A, Nguyen C, Tse WC, Taylor C, McGain F, Thompson K, Hensher M, McAlister S, Higgins AM. How environmental impact is considered in economic evaluations of critical care: a scoping review. Intensive Care Med 2024; 50:36-45. [PMID: 38191675 PMCID: PMC10810918 DOI: 10.1007/s00134-023-07274-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/11/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Health care is a major contributor to climate change, and critical care is one of the sector's highest carbon emitters. Health economic evaluations form an important component of critical care and may be useful in identifying economically efficient and environmentally sustainable strategies. The purpose of this scoping review was to synthesise available literature on whether and how environmental impact is considered in health economic evaluations of critical care. METHODS A robust scoping review methodology was used to identify studies reporting on environmental impact in health economic evaluations of critical care. We searched six academic databases to locate health economic evaluations, costing studies and life cycle assessments of critical care from 1993 to present. RESULTS Four studies met the review's inclusion criteria. Of the 278 health economic evaluations of critical care identified, none incorporated environmental impact into their assessments. Most included studies (n = 3/4) were life cycle assessments, and the remaining study was a prospective observational study. Life cycle assessments used a combination of process-based data collection and modelling to incorporate environmental impact into their economic assessments. CONCLUSIONS Health economic evaluations of critical care have not yet incorporated environmental impact into their assessments, and few life cycle assessments exist that are specific to critical care therapies and treatments. Guidelines and standardisation regarding environmental data collection and reporting in health care are needed to support further research in the field. In the meantime, those planning health economic evaluations should include a process-based life cycle assessment to establish key environmental impacts specific to critical care.
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Affiliation(s)
- Alayna Carrandi
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Level 3, Melbourne, VIC, 3004, Australia
| | - Christina Nguyen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Level 3, Melbourne, VIC, 3004, Australia
- School of Medicine, Monash University, Melbourne, VIC, Australia
| | - Wai Chung Tse
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Level 3, Melbourne, VIC, 3004, Australia
- School of Medicine, Monash University, Melbourne, VIC, Australia
| | - Colman Taylor
- Faculty of Medicine, Critical Care Division, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
| | - Forbes McGain
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
- Department of Anaesthesia, Western Health, Footscray, VIC, Australia
- Department of Intensive Care, Western Health, Footscray, VIC, Australia
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Kelly Thompson
- Faculty of Medicine, Critical Care Division, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
- Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - Martin Hensher
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Scott McAlister
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine, Dentistry and Health Sciences, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
| | - Alisa M Higgins
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Level 3, Melbourne, VIC, 3004, Australia.
- Faculty of Medicine, Critical Care Division, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
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