在不堪重负的卫生系统中管理生命最后一年的温室气体排放:为人类和我们的地球实现范式转变

IF 24.1 1区 医学 Q1 ENVIRONMENTAL SCIENCES Lancet Planetary Health Pub Date : 2024-05-01 DOI:10.1016/S2542-5196(24)00048-2
Myles Sergeant MD , Olivia Ly MD , Sujane Kandasamy PhD , Prof Sonia S Anand MD PhD , Russell J de Souza SD
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引用次数: 0

摘要

医疗保健占全球碳净排放量的 4-4%。医院是资源密集型场所,在病人护理过程中需要使用大量物资,对能源、通风和供暖的需求也很高。本视点调查了病人生命最后一年与医疗相关的排放。生命末期(EOL)是医疗使用和相关排放成倍增加的时期,这主要是由于住院所致,而住院往往与病人的价值观和偏好相悖。本 "观点 "详细阐述了潜在的解决方案,包括促进与患者制定晚期护理计划,以确保患者的临终意愿明确;在治疗局限生命的疾病时,尽早开始姑息护理干预;取消不必要的药物处方,因为药物及其供应链在医疗排放中占很大比例;如果无法提供家庭护理,则在生命的最后一年加强低强度社区护理环境(如临终关怀医院)的使用。我们的分析使用的是加拿大的数据,但分析结果也适用于其他高收入国家。
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Managing greenhouse gas emissions in the terminal year of life in an overwhelmed health system: a paradigm shift for people and our planet

Health care contributes 4·4% of global net carbon emissions. Hospitals are resource-intensive settings, using a large amount of supplies in patient care and have high energy, ventilation, and heating needs. This Viewpoint investigates emissions related to health care in a patient's last year of life. End of life (EOL) is a period when health-care use and associated emissions production increases exponentially due primarily to hospital admissions, which are often at odds with patients’ values and preferences. Potential solutions detailed within this Viewpoint are facilitating advanced care plans with patients to ensure their EOL wishes are clear, beginning palliative care interventions earlier when treating a life-limiting illness, deprescribing unnecessary medications because medications and their supply chains make up a significant portion of health-care emissions, and, enhancing access to low-intensity community care settings (eg, hospices) within the last year of life if home care is not available. Our analysis was done using Canadian data, but the findings can be applied to other high-income countries.

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来源期刊
CiteScore
28.40
自引率
2.30%
发文量
272
审稿时长
8 weeks
期刊介绍: The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
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