Strategies and tactics by which to reduce healthcare’s impact on climate change: A systematic review

Introduction

While healthcare systems are on the frontlines in dealing with climate induced demand for healthcare, they are also major emitters of greenhouse gases (GHG), estimated at over 4.4% of global emissions, with countries ranging from ~4 to 8.5%.(1) Healthcare’s key contribution to the world getting to net zero is to curtail its own emissions. We reviewed the international literature and assessed the ways healthcare systems are mitigating and can mitigate their carbon footprint.

Methods

Search strategy: Eight databases and authoritative reports prior to November 2023 were searched. Teams of investigators screened relevant publications against the inclusion criteria (e.g., in English, and discussed healthcare systems’ impact on climate change).

Quality appraisal: Four quality appraisal tools were applied.

Analysis: Inductive thematic analysis was used.

Results

 - Study selection: 33,737 papers identified; 17,944 screened; 713 assessed for eligibility; 205 papers included.

-  Study characteristics: Most papers focused on the macro healthcare system level (Table 1) and were from high-income countries (USA: n=27, 69%; UK: n=21, 10%; Australia: n=17, 8%; Canada: n=14, 7%; Figure 1).

Measurement of healthcare emissions:

 - Forty-eight publications developed or applied specific models or tools to measure healthcare systems’ GHG emissions (see Table 2 for examples).

Decarbonisation strategies and tactics identified from the literature (Figure 2):