Patient perspectives on hospital's environmental sustainability policy, a cross-sectional survey in the Netherlands

Hospitals are known to have a significant carbon footprint, particularly in high-income countries, yet evidence on patients' view regarding mitigation initiatives within hospital policy is limited.

To examine patients' perspectives on a Dutch hospital-led environmental sustainability policy related to healthy nutrition, waste reduction, sustainable mobility, and disease prevention by lifestyle interventions.

A cross-sectional online survey was conducted in October 2024 among members of a patient panel from a Dutch tertiary University Medical Centre. The survey included four closed-ended questions and one open-ended question on important environmental sustainability initiatives. Descriptive statistics were used, associations between demographics (sex, age, education) and perceived importance were assessed using Chi-square tests and logistic regression. Qualitative responses underwent thematic content analysis.

Of the 2473 invited patients, 1285 (52%) responded to the closed-ended questions and 742 (30%) provided open-ended responses. Disease prevention was rated most important (88%), followed by waste reduction (82%), healthy nutrition (76%), and sustainable mobility (58%). Older age and level of education were significantly associated with perceived importance. Additional themes for hospital policy include medication use, energy consumption, and awareness.

Patients generally support environmental sustainability initiatives in hospital-led policy, particularly those promoting disease prevention, waste reduction, and healthy nutrition. They also identify opportunities for policy development, such as circularity strategies to retain the value of health care products and health promotion strategies focusing on nutrition and lifestyle. Future research should explore how patients wish to participate in shared decision-making on environmental sustainability.