PMID- 20554635
OWN - NLM
STAT- MEDLINE
DCOM- 20110920
LR  - 20131121
IS  - 1741-3850 (Electronic)
IS  - 1741-3842 (Linking)
VI  - 33
IP  - 2
DP  - 2011 Jun
TI  - Changes in travel-related carbon emissions associated with modernization of 
      services for patients with acute myocardial infarction: a case study.
PG  - 272-9
LID - 10.1093/pubmed/fdq048 [doi]
AB  - BACKGROUND: Little attention has been paid on the carbon footprint of different 
      healthcare service models. We examined this question for service models for 
      patients with acute ST elevation myocardial infarction (STEMI). METHODS: We 
      estimated carbon emissions associated with ambulance (patient) transport under a 
      primary percutaneous coronary intervention (pPCI) care model based in tertiary 
      centres, compared with historical emissions under a thrombolysis model based in 
      general hospitals. We used geographical information on 41,449 hospitalizations, 
      and published UK government fuel to carbon emissions conversion factors. RESULTS: 
      The average ambulance journey required for transporting a STEMI patient to its 
      closest care point was 13.0 km under the thrombolysis model and 42.2 km under the 
      pPCI model, producing 3.46 and 11.2 kg of CO(2) emissions, respectively. Thus, 
      introducing pPCI will more than triple ambulance journey associated carbon 
      emissions (by a factor of 3.24). This ratio was robust to sensitivity analysis 
      varying assumptions on conversion factor values; and the number of patients 
      treated. CONCLUSIONS: Introducing pPCI to manage STEMI patients results in 
      substantial carbon emissions increase. Environmental profiling of service 
      modernization projects could motivate carbon control strategies, and care 
      pathways design that will reduce patient transport need. Healthcare planners 
      should consider the environmental legacy of quality improvement initiatives.
FAU - Zander, Alexis
AU  - Zander A
AD  - Department of Public Health and Primary Care, University of Cambridge School of 
      Clinical Medicine, Institute of Public Health, Robinson Way, Forvie Site, 
      Cambridge CB2 0SR, UK.
FAU - Niggebrugge, Aphrodite
AU  - Niggebrugge A
FAU - Pencheon, David
AU  - Pencheon D
FAU - Lyratzopoulos, Georgios
AU  - Lyratzopoulos G
LA  - eng
PT  - Journal Article
DEP - 20100616
PL  - England
TA  - J Public Health (Oxf)
JT  - Journal of public health (Oxford, England)
JID - 101188638
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
MH  - Angioplasty, Balloon, Coronary
MH  - Carbon Dioxide
MH  - *Carbon Footprint/statistics & numerical data
MH  - Electrocardiography
MH  - England
MH  - Geography
MH  - Health Policy
MH  - Health Services Accessibility
MH  - Humans
MH  - *Myocardial Infarction/therapy
MH  - State Medicine
MH  - Thrombolytic Therapy
MH  - Transportation of Patients/*statistics & numerical data
MH  - Travel
EDAT- 2010/06/18 06:00
MHDA- 2011/09/21 06:00
CRDT- 2010/06/18 06:00
PHST- 2010/06/18 06:00 [entrez]
PHST- 2010/06/18 06:00 [pubmed]
PHST- 2011/09/21 06:00 [medline]
AID - fdq048 [pii]
AID - 10.1093/pubmed/fdq048 [doi]
PST - ppublish
SO  - J Public Health (Oxf). 2011 Jun;33(2):272-9. doi: 10.1093/pubmed/fdq048. Epub 
      2010 Jun 16.