Greenhouse gas emissions of an outpatient care service: a cost-based approach

Climate change is already having an impact on global health and will continue to do so even more. Heat waves and extreme weather events are only part of the impact. Adapting health services to these threats is only partially possible, so another focus should be on mitigating climate change by minimising greenhouse gas emissions. In this context, health care can play an important role. However, evidence about greenhouse gas emission hotspots and alternative action to mitigate greenhouse gas emissions is needed for the shift to a climate-friendly health system.

In this paper, the greenhouse gas emissions of an outpatient care service will be calculated. On the one hand, focal points of the emissions will be identified and the effects of climate-friendly measures calculated. In order to calculate a comprehensive footprint, a hybrid approach was chosen in which emissions from electricity, gas and fuels are determined on the basis of quantities, and emissions resulting from the production of consumer goods are calculated using cost-based emission factors. The expenditure and consumption data required come from a care service in Lower Saxony providing for 132 people in need of care.

The outpatient care service emitted a total of 37,258 kg CO₂eq in 2018, i.e. roughly 282 kg CO₂eq per year and person in need of care. The production (15%) and combustion of fuels (68%) accounted for the largest share of 73%. By switching to diesel vehicles, the care service could save 7% of the annual greenhouse gas emissions and by switching to electric vehicles up to 30%.

The study shows that the outpatient care service produces greenhouse gas emissions of about 282 kg CO₂eq per year and person in need of care, which is a relevant amount given the average per capita emission of 7.9 kg CO₂ in Germany. However, these emissions can be reduced by more than half by making the relatively easy switch to electric cars. Limitations of the study relate to potential inaccuracies of the cost-based emission factors and the lack of information about the kilometers driven and the fuel consumed.

The majority of the emissions of an ambulatory care service comes from the production and combustion of fuels. However, this source can be significantly reduced by switching to modern technologies. To validate the results of this study, further studies should be conducted, preferably with a bottom-up methodology.