Tesi etd-09272024-090838
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Tipo di tesi
Dottorato
Autore
BENEDETTO, VERA
URN
etd-09272024-090838
Titolo
Restoring balance: connecting environmental sustainability with healthcare
Settore scientifico disciplinare
SECS-P/08
Corso di studi
Istituto di Management - PHD IN HEALTH SCIENCE, TECHNOLOGY AND MANAGEMENT
Commissione
relatore Prof.ssa NUTI, SABINA
Membro Prof. EMDIN, MICHELE
Relatore Prof. AMUNNI, GIANNI
Membro Dott.ssa FORNI, SILVIA
Membro Prof. EMDIN, MICHELE
Relatore Prof. AMUNNI, GIANNI
Membro Dott.ssa FORNI, SILVIA
Parole chiave
- healthcare planning
- environmental sustainability
- equity
- proximity care
Data inizio appello
06/01/2025;
Disponibilità
parziale
Riassunto analitico
This doctoral research explores the integration of environmental sustainability into healthcare planning and assessment within the Italian National Health Service (SSN), addressing a pressing need for healthcare systems to evolve in response to global environmental challenges. Historically, universal healthcare systems have focused on three core goals: quality, financial sustainability, and equity. While these objectives remain essential, emerging concerns about environmental sustainability necessitate a broader approach. This research examines how sustainability can be embedded within healthcare planning and assessment, particularly by leveraging proximity care to reduce environmental impacts and enhance equity.
A central theme of this work is the concept of proximity care, which refers to designing healthcare systems that reduce physical and logistical distances for patients. Long travel distances to healthcare facilities often exacerbate inequities, especially in geographically dispersed or rural areas, limiting access to preventive services and resulting in disparities in health outcomes. By improving local access to care, proximity care not only enhances equity but also reduces the environmental footprint associated with transportation and hospital-based services. This dual benefit aligns with broader global goals for sustainability, as outlined by the United Nations’ Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 13 (Climate Action). The Italian SSN has long been committed to quality, equity, and sustainability. However, integrating environmental sustainability into healthcare remains a relatively new challenge. Italy’s territorial care policies, especially in the wake of the COVID-19 pandemic, have begun to address this gap through some reforms, especially through those which seeks to enhance primary and territorial care. Nevertheless, a comprehensive integration of environmental sustainability into healthcare strategy remains uneven, particularly at regional and sub-regional levels.
The thesis is built upon three core research outputs. The first study, a scoping review, assesses the current literature to explore the relationship between proximity care and environmental sustainability in healthcare. Findings reveal that while there is substantial interest in these themes, there is a need for more empirical evidence to quantify the environmental benefits of proximity care models. The second study focuses on the development of performance indicators for measuring environmental sustainability within healthcare systems. This work highlights the importance of establishing clear metrics to track sustainability efforts, which are crucial for both improving system performance and promoting accountability in healthcare management. The final study examines the possibility of implementation of the Proxy Screening project in a rural area of Tuscany, Italy, which introduces a mobile multi-screening model that delivers healthcare services directly to residents. This model effectively addresses both equity of access and environmental issues by minimising travel distances and utilising digital health tools. The project's success highlights the critical role of community engagement, continuity of care, and cross-sector collaboration in achieving sustainability and equity objectives.
Overall, this thesis advocates for the integration of environmental sustainability into healthcare system planning and assessment processes. By incorporating proximity care and environmental indicators, healthcare systems can enhance both equity and sustainability, ultimately improving health outcomes while reducing environmental impact.
A central theme of this work is the concept of proximity care, which refers to designing healthcare systems that reduce physical and logistical distances for patients. Long travel distances to healthcare facilities often exacerbate inequities, especially in geographically dispersed or rural areas, limiting access to preventive services and resulting in disparities in health outcomes. By improving local access to care, proximity care not only enhances equity but also reduces the environmental footprint associated with transportation and hospital-based services. This dual benefit aligns with broader global goals for sustainability, as outlined by the United Nations’ Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 13 (Climate Action). The Italian SSN has long been committed to quality, equity, and sustainability. However, integrating environmental sustainability into healthcare remains a relatively new challenge. Italy’s territorial care policies, especially in the wake of the COVID-19 pandemic, have begun to address this gap through some reforms, especially through those which seeks to enhance primary and territorial care. Nevertheless, a comprehensive integration of environmental sustainability into healthcare strategy remains uneven, particularly at regional and sub-regional levels.
The thesis is built upon three core research outputs. The first study, a scoping review, assesses the current literature to explore the relationship between proximity care and environmental sustainability in healthcare. Findings reveal that while there is substantial interest in these themes, there is a need for more empirical evidence to quantify the environmental benefits of proximity care models. The second study focuses on the development of performance indicators for measuring environmental sustainability within healthcare systems. This work highlights the importance of establishing clear metrics to track sustainability efforts, which are crucial for both improving system performance and promoting accountability in healthcare management. The final study examines the possibility of implementation of the Proxy Screening project in a rural area of Tuscany, Italy, which introduces a mobile multi-screening model that delivers healthcare services directly to residents. This model effectively addresses both equity of access and environmental issues by minimising travel distances and utilising digital health tools. The project's success highlights the critical role of community engagement, continuity of care, and cross-sector collaboration in achieving sustainability and equity objectives.
Overall, this thesis advocates for the integration of environmental sustainability into healthcare system planning and assessment processes. By incorporating proximity care and environmental indicators, healthcare systems can enhance both equity and sustainability, ultimately improving health outcomes while reducing environmental impact.
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