title: Dialysis and the environment: comparing home and unit based haemodialysis.
abstract: Dialysis, with its high dependence upon technology, disposable products and transport requirements, presents an unusual perspective for environmental management. This study considers and compares the environmental aspects arising from the provision of haemodialysis (HD) in the hospital and home setting. Resource items were measured at two levels of aggregation--unit and individual patient. Unit level items applied to common resources used for HD and require apportioning appropriately with patient level items that could be attributable to individuals. The data was measured in standard units such as hours and number of treatments or apportioned appropriately. With equivalent emissions calculated as CO2 annually per patient for standard HD. The findings indicate that HD in the home offers a net reduction in CO2 emissions per patient annually compared to hospital based HD, and provides an overview of how healthcare provision and the use of resources can be measured, enabling refinement in environmental management plans.
authors.affiliation: Hanbury Dialysis Unit, The Royal London Hospital, London, UK. Ray.james@bartsandthelondon.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: James
mesh_terms: D000393:Air Pollutants / Q000032:analysis; D002245:Carbon Dioxide / Q000032:analysis; D002980:Climate; D003246:Conservation of Energy Resources / Q000191:economics* / Q000379:methods; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs / Q000706:statistics & numerical data; D004782:Environmental Health / Q000191:economics*; D004865:Equipment and Supplies, Hospital / Q000191:economics; D017752:Greenhouse Effect; D006436:Hemodialysis Units, Hospital / Q000191:economics*; D006437:Hemodialysis, Home / Q000191:economics*; D006796:Household Work / Q000191:economics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D017744:Medical Waste Disposal / Q000191:economics; D015401:Nursing Administration Research; D010561:Personnel Staffing and Scheduling / Q000191:economics; D014186:Transportation / Q000191:economics; D014195:Travel / Q000191:economics; D006113:United Kingdom / Q000453:epidemiology; D014881:Water Supply / Q000191:economics; D000078329:Workforce; D016526:Workload / Q000191:economics
chemical_list: D000393:Air Pollutants; D017744:Medical Waste Disposal; D002245:Carbon Dioxide