Reducing the Carbon Footprint of China’s Health Sector through Clinical Pathway Modification and Disease Management, Based on Dialysis Cases

Abstract Background The healthcare sector is a significant contributor to greenhouse gas emissions. Reducing the carbon footprint by adjusting the medical disease management structure is important for China. Methods We conducted a case study, estimated the annual carbon footprint of both haemodialysis and peritoneal dialysis patients and compared demographic characteristics and carbon consumption in each category between haemodialysis (HD) and peritoneal dialysis (PD). Linear regression was used to explore factors potentially influencing the carbon footprint. Findings 271 dialysis patients (143 HD and 128 PD) were included in study. The carbon footprints of HD and PD were 3150.3 and 471.3 kgCO 2 -eq. The most consumed parts of HD are dialysis equipment (42%) and medical consumables (22%), and of PD are discharge medication (45%) and medical supplies (45%). The carbon footprints of HD and PD did not change significantly with the extension of dialysis time and remained stable at 2500–3500 and 200–800 kgCO 2 -eq. The influencing factors of them were different; some had opposite effects due to the different treatment modalities. Conclusions Our study demonstrated the feasibility of clinical pathway modification to reduce the carbon footprint. Our findings suggest that promoting peritoneal dialysis could effectively reduce the healthcare system's carbon footprint and promote sustainability.