ArticleThe Lancet. Planetary health2023
Health-care systems' resource footprints and their access and quality in 49 regions between 1995 and 2015: an input-output analysis.
Article in The Lancet. Planetary health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Systematic Review: Ultrasound Goes Echo-Decarbonising Inflammatory Bowel Disease Care Through Intestinal Ultrasound.Alimentary pharmacology & therapeutics · 2025Pooled it
- Strategies and tactics to reduce the impact of healthcare on climate change: systematic review.BMJ (Clinical research ed.) · 2024Pooled it
- Greener care, smarter spending: economic opportunities in sustainable nephrology.Clinical kidney journal · 2026Review
- Adapting and mitigating: an exploratory Delphi approach to climate change impacts on healthcare institutions in Switzerland.Dialogues in health · 2026Article
- Ethical dilemmas in climate change and healthcare delivery: a cross-sectional survey of US patient perspectives.BMC medicine · 2026Article
- Informing the patient of the placebo option: an ethical necessity likely to reduce inappropriate psychotropic prescriptions?Therapeutic advances in psychopharmacology · 2026Review
- The role of timely assessment of appropriate care in reducing greenhouse gas emissions in intensive care medicine.Annals of intensive care · 2026Article
- Resources consumption and environmental impacts of the DYNAMIC digital health intervention aimed at improving quality of care for sick children in Tanzania: a life cycle assessment.Frontiers in digital health · 2026Article
- UK Public Focus Groups on Healthcare's Environmental Impacts: A Critical Analysis of Co-Benefits Approaches.Sociology of health & illness · 2025Article
- Article
- Health system performance on greenhouse gas emissions, climate change and development status in 38 OECD countries.Scientific reports · 2025Article
- Rethinking Hospital Sustainability: Circular Economy and Health Literacy Comment on "A Review of the Applicability of Current Green Practices in Healthcare Facilities".International journal of health policy and management · 2025Article
- Greening healthcare and slashing carbon emissions through telemedicine: a cross-sectional study from over 50 thousand remote consults at a leading tertiary hospital.Frontiers in digital health · 2025Article
- The environmental impact and sustainability of infection control practices: a systematic scoping review.Antimicrobial resistance and infection control · 2024Article
- Estimating the Carbon Footprint of Healthcare in the Canton of Geneva and Reduction Scenarios for 2030 and 2040.International journal of environmental research and public health · 2024Article
- The Impact of Climate Change, Pollution, and Biodiversity Loss on Digestive Health and Disease.Gastro hep advances · 2024Review
- Environmental impact of urine analyses: Comparison of manual, semi and fully automated analytical workflows.The journal of climate change and healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundStrategies to reduce the environmental impact of health care are often limited to greenhouse gas emissions. To broaden their scope, our aim was to determine the evolution of the resource footprints, dependency, and efficiency of health-care systems and to determine the relationship between this evolution and their Healthcare Access and Quality (HAQ) index.
methodsWe carried out an input-output analysis of 49 health-care systems from 1995 to 2015. We harmonised the EXIOBASE v3.8.2 database-providing data for 49 world regions-to the World Health Organization Health Expenditures Database. We then performed a panel data analysis to understand the relationship between Healthcare Access and Quality index and energy footprint per capita of health-care systems. EXIOBASE3 does not provide measurement errors so it was not possible to propagate the uncertainties as can be done with other input-output databases.
findingsHealth-care systems' footprint increased over the past two decades, reaching 7% of global non-metallic minerals footprint, 4% of global metal ores footprint, and 5% of global fossil fuels footprint in 2013. This increase was mostly due to China, rising from 7% of the non-metallic minerals footprint in 1995 to 45% in 2013. 80% of the health-care systems studied were dependent at more than 50% on fossil fuel imports. The energy footprint per capita was correlated exponentially with the HAQ index but some countries performed much better than others at a given energy footprint. Health-care systems have not become more efficient between 2002 and 2015.
interpretationHealth-care systems' resources footprint are exponentially linked to their HAQ. Both prevention and efficiency measures will be needed to change this relationship. If it is not enough, high-income countries will have to choose between further reducing the resource consumption of their health-care systems or shifting the efforts to other sectors, health being considered an incompressible need. We call for the creation of a HAQE (health-care access, quality, and efficiency) index that would add resource efficiency to access and quality when ranking health-care systems.
fundingThe Shift Project.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.