Utilizing off-the-shelf LCA methods to develop a ‘triple bottom line’ auditing tool for global cataract surgical services

Thiel, Cassandra L.; Cassels-Brown, Andy; Goel, Hena; Stancliffe, Rachel; Steinbach, Ingeborg; Thomas, Peter; Vendries, Jorge

doi:10.1016/j.resconrec.2020.104805

Cited by 14 publications

(32 citation statements)

References 27 publications

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“…For example, supply prices are used to calculate GHGs from supply manufacture and these models are not as accurate as country-specific input–output models or process-based LCA methods. 23 The energy calculations are made by allocating the hospital’s total electricity use to the floor area and case duration of the surgery, rather than some metering in greater detail. In addition, energy usage does not include non-electric heating sources, meaning GHGs in colder climates will likely be underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…The Eyefficiency tool consists of a website and mobile phone application (app) with a built-in toolkit on how to use the tool, thus avoiding the need for external support. 23 The Eyefficiency tool successfully completed its first phase of piloting at four sites from the UK, India and South Africa in 2017. 23 On confirming its feasibility, Eyefficiency garnered further support for continued development from the IAPB and Standard Chartered Bank’s Seeing is Believing grant.…”

Section: Design and Methodsmentioning

confidence: 99%

“… 23 The Eyefficiency tool successfully completed its first phase of piloting at four sites from the UK, India and South Africa in 2017. 23 On confirming its feasibility, Eyefficiency garnered further support for continued development from the IAPB and Standard Chartered Bank’s Seeing is Believing grant. This helped the tool move on to its second phase of beta testing, which has completed two rounds, to date.…”

Section: Design and Methodsmentioning

confidence: 99%

“…Further details on the methods can be found in Thiel et al ’s 2020 article. 23 …”

Section: Design and Methodsmentioning

confidence: 99%

“…Further details on the methods can be found in Thiel et al's 2020 article. 23 After calculating the productivity (case duration), cost per case and GHG emissions per case, we compared across sites using descriptive statistics.…”

Section: Beta Site Selection and Timelinementioning

confidence: 99%

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Improving productivity, costs and environmental impact in International Eye Health Services: using the ‘Eyefficiency’ cataract surgical services auditing tool to assess the value of cataract surgical services

Goel

Wemyss

Harris³

et al. 2021

BMJ Open Ophth

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ObjectiveThough one of the most common surgeries, there is limited information on variability of practices in cataract surgeries. ‘Eyefficiency’ is a cataract surgical services auditing tool to help global units improve their surgical productivity and reduce their costs, waste generation and carbon footprint. The aim of the present research is to identify variability and efficiency opportunities in cataract surgical practices globally.Methods and Analysis9 global cataract surgical facilities used the Eyefficiency tool to collect facility-level data (staffing, pathway steps, costs of supplies and energy use), and live time-and-motion data. A point person from each site gathered and reported data on 1 week or 30 consecutive cataract surgeries. Environmental life cycle assessment and descriptive statistics were used to quantify productivity, costs and carbon footprint. The main outcomes were estimates of productivity, costs, greenhouse gas emissions, and solid waste generation per-case at each site.ResultsNine participating sites recorded 475 cataract extractions (a mix of phacoemulsification and manual small incision). Cases per hour ranged from 1.7 to 4.48 at single-bed sites and 1.47 to 4.25 at dual-bed sites. Average per-case expenditures ranged between £31.55 and £399.34, with a majority of costs attributable to medical equipment and supplies. Average solid waste ranged between 0.19 kg and 4.27 kg per phacoemulsification, and greenhouse gases ranged from 41 kg carbon dioxide equivalents (CO2e) to 130 kg CO2e per phacoemulsification.ConclusionResults demonstrate the global diversity of cataract surgical services and non-clinical metrics. Eyefficiency supports local decision-making for resource efficiency and could help identify regional or global best practices for optimising productivity, costs and environmental impact of cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Design and Methodsmentioning

confidence: 99%

Section: Design and Methodsmentioning

confidence: 99%

“…Further details on the methods can be found in Thiel et al ’s 2020 article. 23 …”

Section: Design and Methodsmentioning

confidence: 99%

Section: Beta Site Selection and Timelinementioning

confidence: 99%

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Improving productivity, costs and environmental impact in International Eye Health Services: using the ‘Eyefficiency’ cataract surgical services auditing tool to assess the value of cataract surgical services

Goel

Wemyss

Harris³

et al. 2021

BMJ Open Ophth

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Nachhaltigkeit in der Augenheilkunde

et al. 2022

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Exploratory Approach to Incorporating Carbon Footprint in Health Technology Assessment (HTA) Modelling: Cost-Effectiveness Analysis of Health Interventions in the United Kingdom

Kindred,

Shabrina,

Zakiyah

2023

Appl Health Econ Health Policy

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Background Health interventions contribute to the production of greenhouse gas emissions. Thus, reducing carbon footprint is essential in supporting the UK National Health Service (NHS) pathway to net zero. This study explores the approach in which carbon footprint can be included when applying Health Technology Assessment (HTA) modelling using obesity intervention in the United Kingdom (UK) as a case study. Methods Using decision analytic modelling, we conducted an HTA incorporating the impacts of obesity-related treatment decisions on UK carbon emissions. A cohort Markov model was used to track the emissions of the UK population after receiving one of two obesity treatments: semaglutide and bariatric surgery. Results This study introduced two new carbon measurement tools that may be useful for future policymaking, incremental carbon footprint effectiveness ratio (ICFER) and incremental carbon footprint cost ratio (ICFCR), which made it possible to assess the emission impacts of proposed health policies. Using the obesity intervention case study, we found that both treatments have an incremental cost-effectiveness ratio (ICER) of < £20,000 per quality-adjusted life-years (QALYs) gained. This is below the UK threshold, indicating that these are cost-effective treatments for obesity, but could increase the NHS carbon footprint. However, it could reduce the overall UK societal carbon footprint by reducing the number of people with obesity. The ICFCR shows a reduction of 1.13–4.51 kgCO 2 e (kilogram of carbon dioxide equivalent) for every pound spent on obesity treatment. Conclusion This study illustrates a case study for estimating the effect of health policies on carbon emissions and provides a quantitative measure for obesity-related treatment decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s40258-023-00839-z.

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Utilizing off-the-shelf LCA methods to develop a ‘triple bottom line’ auditing tool for global cataract surgical services

Cited by 14 publications

References 27 publications

Improving productivity, costs and environmental impact in International Eye Health Services: using the ‘Eyefficiency’ cataract surgical services auditing tool to assess the value of cataract surgical services

Improving productivity, costs and environmental impact in International Eye Health Services: using the ‘Eyefficiency’ cataract surgical services auditing tool to assess the value of cataract surgical services

Nachhaltigkeit in der Augenheilkunde

Exploratory Approach to Incorporating Carbon Footprint in Health Technology Assessment (HTA) Modelling: Cost-Effectiveness Analysis of Health Interventions in the United Kingdom

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