Estimating the Cost and Carbon Output of Musculoskeletal Primary Care Management Decisions: A Retrospective Analysis of Electronic Health Records.

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES

International Journal of Health Planning and Management Pub Date : 2025-03-22 DOI:10.1002/hpm.3919

Alex Braybrooke, Melissa Pegg, Rebecca Naylor, James Bailey, James Scott, Roanna Burgess, Dahai Yu, Simon Wathall, Kelvin P Jordan, Robert Malcolm, Hayden Holmes, George Peat, Anirban Banerjee, Jonathan C Hill

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引用次数: 0

Abstract

Background: Healthcare accounts for up to 5% of worldwide carbon emissions and costs global economies an estimated $9 trillion annually. Primary care accounts for up to one-fifth of all NHS carbon emissions, with musculoskeletal (MSK) pain accounting for 14%-30% of all primary care consultations.

Method: A cost-carbon calculator model was used to undertake a retrospective economic and environmental analysis of resource use for non-inflammatory MSK pain primary care consulters. Data used to populate the model was derived from Electronic Health Records and patient surveys collected during The Multi-level Integrated Data for Musculoskeletal Health Intelligence and ActionS GP Study. The model was utilised to estimate the mean (with 95%CI's) cost and carbon output per MSK consulter, while also examining variations at two levels: (a) the Primary Care Network (PCN), and (b) the consulter's index MSK pain site.

Results: One thousand eight hundred seventy-five individuals from 30 NHS primary care practices across 13 PCNs were eligible for EHR and survey data analysis. The mean carbon and cost output per person (over 6 months) was 46.91 kg CO₂e (95% CIs; 45.02, 48.81 kg CO₂e) and £182.65 (95% CIs; £178.69, £190.62), respectively, with substantial variation observed across PCNs. The resource category with the highest carbon footprint was consistently pharmacological intervention across all PCNs. Individuals who consulted for multisite/widespread pain and back pain had the highest mean carbon and cost output respectively.

Conclusion: This is the first study, we are aware of, that presents data on both the environmental and economic impact of the primary care of non-inflammatory MSK pain. Future work should focus on benchmarking the cost and carbon output of MSK care pathways and standardising methods that are implemented to influence sustainable practice and policy development.

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估算肌肉骨骼基层医疗管理决策的成本和碳排放量：电子健康记录回顾性分析》。

背景：医疗保健占全球碳排放量的5%，每年给全球经济造成约9万亿美元的损失。初级保健占NHS所有碳排放量的五分之一，肌肉骨骼（MSK）疼痛占所有初级保健咨询的14%-30%。方法：采用成本-碳计算器模型对非炎症性MSK疼痛初级保健咨询师的资源使用进行回顾性经济和环境分析。用于填充模型的数据来自电子健康记录和患者调查，这些数据是在“肌肉骨骼健康情报和行动GP研究的多层次集成数据”中收集的。该模型用于估计每个MSK咨询师的平均（95%CI）成本和碳排放量，同时还检查了两个水平的变化：(a)初级保健网络（PCN）和(b)咨询师的MSK疼痛部位指数。结果：来自13个pcn的30个NHS初级保健实践的1875个人符合电子病历和调查数据分析的条件。每人（超过6个月）的平均碳和成本产出为46.91 kg CO2e (95% ci；45.02, 48.81千克二氧化碳当量)和182.65英镑(95% ci；分别为178.69英镑和190.62英镑)，不同pcn之间的差异很大。在所有pcn中，碳足迹最高的资源类别始终是药物干预。咨询多部位/广泛性疼痛和背部疼痛的个体分别具有最高的平均碳和成本产出。结论：这是我们所知的第一项研究，提供了非炎症性MSK疼痛初级保健对环境和经济影响的数据。未来的工作应侧重于确定MSK护理途径的成本和碳排放基准，并使实施的方法标准化，以影响可持续实践和政策制定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Health Planning and Management Multiple-

CiteScore

4.50

自引率

3.70%

发文量

197

期刊介绍： Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.