Life Cycle Assessments in Healthcare: Insights and Standardisation Needs

Life cycle assessment is increasingly applied in healthcare, yet the healthcare-specific standardisation landscape and its relation to current practice remain unclear. This study maps existing frameworks and analyses their alignment with published healthcare LCA to identify standardisation gaps. Healthcare-specific standards and product category rules were identified through grey literature searches. Published healthcare LCA studies were quantitatively analysed and compared with the identified frameworks to assess methodological convergence and divergence. Six healthcare-specific frameworks were identified: five address medical products, one addresses services, and none cover organisational assessment. Product-level applications showed strong alignment in structural modelling elements including system boundaries and life cycle stages, while substantial heterogeneity persisted in functional unit definitions and impact assessment approaches. Service and organisational assessments showed broader variability in modelling approaches, functional units, and system boundary conceptualisations, indicating distinct modelling logics of healthcare delivery across assessment levels. Healthcare LCA practice is consistent with ISO-based principles but lacks a shared conceptual modelling logic for healthcare delivery systems. Rather than reflecting a single methodological paradigm, healthcare LCA combines product-, intervention-, pathway-, and organisational-oriented approaches. Standardisation efforts should therefore focus not only on harmonising calculation methods but also on developing healthcare-specific modelling conventions for products, services, and organisational structures.