Holistic Sustainable Primary Health Care Policies for Connecting Diagnosis-Related Groups with Sustainable Finance Models

Health systems worldwide are under pressure to simultaneously address rising costs, climate change, and health inequalities. This study proposes a new holistic policy for sustainable Primary Health Care (PHC) that combines the strategic use of Diagnosis Related Groups (DRGs) with environmental and finance sustainability practices. The model was developed through an extensive literature review and assessment of current policy frameworks such as Corporate Sustainable Reporting Directive and European Sustainability Reporting Standards (CSRD/ESRS), and aims to bridge the gap between clinical effectiveness, social protection, financial efficiency, and environmental responsibility. By moving away from the traditional, hospital-centered, one-dimensional focus of health care, the model reorients the health care system toward a multidimensional-holistic use of all available health resources, creating a resilient and sustainable health system that is aligned with environmental sensitivity and social protection under optimum financial efficiency. Integrating DRGs into PHC increases transparency and efficiency in resource allocation, reduces health inequities, and promotes financial sustainability. At the same time, the adoption of green health practices and the incorporation of those practices in the DRGS, such as the use of cost of energy and renewable energy and cost of waste and waste reduction practices, accelerates the achievement of the Sustainable Development Goals (SDGs). By improving preventive services, reducing avoidable hospitalizations, and establishing flexible, sustainable financing mechanisms, population health outcomes can be significantly improved. The findings suggest that a sustainable, adaptive, and dynamic PHC resilience system can serve as a central pillar for achieving health for all, reducing inequalities, strengthening social justice, and promoting planetary health, offering a transformative pathway to a greener and more equitable future for health care. These findings may inform health policy makers, sustainability officers, and primary care planners seeking to design integrated and accountable PHC systems.