IDEAS home Printed from https://ideas.repec.org/a/bla/inecol/v26y2022i4p1528-1542.html
   My bibliography  Save this article

Carbon footprinting for hospital care pathways based on routine diagnosis‐related group (DRG) accounting data in Germany: An application to acute decompensated heart failure

Author

Listed:
  • Xiange Zhang
  • Klaus Albrecht
  • Stefan Herget‐Rosenthal
  • Wolf H. Rogowski

Abstract

A general framework is developed using routine German diagnosis‐related group (G‐DRG) accounting data to estimate carbon footprints of hospital care pathways in the context of patients with acute decompensated heart failure (ADHF) admitted to the Red Cross Hospital Bremen in 2018. Financial activity data encompass G‐DRG material costs from hospital accounting data submitted to the Institute for the Hospital Remuneration System. A set of seven greenhouse gases (GHGs) is included. Environmentally extended input–output emission factors (EFs) compiled by Eurostat are employed. EFs of cost modules are calculated separately considering respective emissions' intensities. Total emissions reach 72,652 kg carbon dioxide equivalent (CO2e) (nonbiogenic: 85.5%; biogenic: 14.5%) for general inpatient care throughout ADHF patient care pathways in 2018. Emissions from normal wards account for the largest proportion (74.8%) of total emissions for ADHF patients. Compared to other matched industry categories, cost‐types covered by the industry category D “electricity, steam and air conditioning supply” cause the vast majority (approximately 87%) of total emissions. GHG emissions per unit of analysis, per bed day, and per euro are estimated at 263, 32, and 0.31 kg CO2e, respectively. Although this framework is currently limited to hospitals that participate in the G‐DRG calculation scheme or apply these accounting standards on a voluntary basis, it has particular advantages that render it amenable to other contexts. It enables the calculation of emissions separately for each cost module considering its specific emission intensity, which can improve the accuracy of estimates.

Suggested Citation

  • Xiange Zhang & Klaus Albrecht & Stefan Herget‐Rosenthal & Wolf H. Rogowski, 2022. "Carbon footprinting for hospital care pathways based on routine diagnosis‐related group (DRG) accounting data in Germany: An application to acute decompensated heart failure," Journal of Industrial Ecology, Yale University, vol. 26(4), pages 1528-1542, August.
  • Handle: RePEc:bla:inecol:v:26:y:2022:i:4:p:1528-1542
    DOI: 10.1111/jiec.13294
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jiec.13294
    Download Restriction: no

    File URL: https://libkey.io/10.1111/jiec.13294?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lukas Kwietniewski & Mareike Heimeshoff & Jonas Schreyögg, 2017. "Estimation of a physician practice cost function," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 481-494, May.
    2. Schreyögg, Jonas & Bäumler, Michael & Busse, Reinhard, 2009. "Balancing adoption and affordability of medical devices in Europe," Health Policy, Elsevier, vol. 92(2-3), pages 218-224, October.
    3. Gartner, Daniel & Kolisch, Rainer, 2014. "Scheduling the hospital-wide flow of elective patients," European Journal of Operational Research, Elsevier, vol. 233(3), pages 689-699.
    4. Andrew Street & Kirsi Vitikainen & Afsaneh Bjorvatn & Anne Hvenegaard, 2007. "Introducing activity-based financing: a review of experience in Australia, Denmark, Norway and Sweden," Working Papers 030cherp, Centre for Health Economics, University of York.
    5. Miraldo, M & Crea, G & Longo, R & Street, A, 2014. "Collusion in regulated pluralistic markets," Working Papers 15402, Imperial College, London, Imperial College Business School.
    6. Chrysanthos D. Christou & Eleni C. Athanasiadou & Andreas I. Tooulias & Argyrios Tzamalis & Georgios Tsoulfas, 2022. "The process of estimating the cost of surgery: Providing a practical framework for surgeons," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 1926-1940, July.
    7. Raulinajtys-Grzybek, Monika, 2014. "Cost accounting models used for price-setting of health services: An international review," Health Policy, Elsevier, vol. 118(3), pages 341-353.
    8. Stefan Felder, 2009. "The variance of length of stay and the optimal DRG outlier payments," International Journal of Health Economics and Management, Springer, vol. 9(3), pages 279-289, September.
    9. Roberta Longo & Marisa Miraldo & Andrew Street, 2008. "Price regulation of pluralistic markets subject to provider collusion," Working Papers 045cherp, Centre for Health Economics, University of York.
    10. Hamada, Hironori & Sekimoto, Miho & Imanaka, Yuichi, 2012. "Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan," Health Policy, Elsevier, vol. 107(2), pages 194-201.
    11. Kristina Kast & Carl-Philipp Wachter & Oliver Schöffski & Martina Rimmele, 2021. "Economic evidence with respect to cost-effectiveness of the transitional care model among geriatric patients discharged from hospital to home: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 961-975, August.
    12. Matthew Grennan & Robert J. Town, 2020. "Regulating Innovation with Uncertain Quality: Information, Risk, and Access in Medical Devices," American Economic Review, American Economic Association, vol. 110(1), pages 120-161, January.
    13. Jérôme LARTIGAU, 2013. "Prospective Payment Systems And Evolution Of Management Control In French Hospitals: An Overview," Scientific Bulletin - Economic Sciences, University of Pitesti, vol. 12(2), pages 24-39.
    14. Vogl, Matthias, 2014. "Hospital financing: Calculating inpatient capital costs in Germany with a comparative view on operating costs and the English costing scheme," Health Policy, Elsevier, vol. 115(2), pages 141-151.
    15. Chris Bojke & Katja Grašič & Andrew Street, 2018. "How should hospital reimbursement be refined to support concentration of complex care services?," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 26-38, January.
    16. Machiel Westerdijk & Joost Zuurbier & Martijn Ludwig & Sarah Prins, 2012. "Defining care products to finance health care in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 203-221, April.
    17. Sutherland, Jason Murray & Walker, Jan, 2008. "Challenges of rehabilitation case mix measurement in Ontario hospitals," Health Policy, Elsevier, vol. 85(3), pages 336-348, March.
    18. Baxter, Pamela E. & Hewko, Sarah J. & Pfaff, Kathryn A. & Cleghorn, Laura & Cunningham, Barbara J. & Elston, Dawn & Cummings, Greta G., 2015. "Leaders’ experiences and perceptions implementing activity-based funding and pay-for-performance hospital funding models: A systematic review," Health Policy, Elsevier, vol. 119(8), pages 1096-1110.
    19. Giovanni Iuzzolino, 2008. "Demand and supply of hospital services. International trends," Questioni di Economia e Finanza (Occasional Papers) 27, Bank of Italy, Economic Research and International Relations Area.
    20. Jonas Schreyögg, 2008. "A micro‐costing approach to estimating hospital costs for appendectomy in a Cross‐European context," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 59-69, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:inecol:v:26:y:2022:i:4:p:1528-1542. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=1088-1980 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.