willi haas, ulli weisz iff institute of social ecology vienna, klagenfurt university
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A significant sustainability question: Increase number of health treatments or increase public health?. Willi Haas, Ulli Weisz IFF Institute of Social Ecology Vienna, Klagenfurt University td- conference, September 2010, Geneva, Switzerland. health & sd. health & sd. - PowerPoint PPT PresentationTRANSCRIPT
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 1
hospitals & sdhealth & sd environ. efficiency productoutcome quality
A significant sustainability question: Increase number of health treatments or increase public health?
Willi Haas, Ulli WeiszIFF Institute of Social Ecology Vienna, Klagenfurt University
td-conference, September 2010, Geneva, Switzerland
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 2
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• manifold relations between health and sustainable development
• public health is an objective of sustainable development
• public health is a means to achieve sustainable development
health & sdhealth & sd
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 3
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• health care systems in developed countries contribute significantly to climate change
• climate change threatens public health
health & sdhealth & sd
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 4
hospitals & sdhealth & sd environ. efficiency productoutcome quality
Anteil der Krankenhäuser am österreichischen CO2-Ausstoss inkl. Vorleistungen
Source: own calculations using an extended IO-table for Austria based on NAMEA 2000 and national accounts 2000
HOSPITALS
Share of hospitals on Austrian CO2 emissions 2000 (direct and indirect)
17.043
13.724
22.77017.326
0
5.000
10.000
15.000
20.000
25.000
1997 1998 1999 2000 2001 2002 2003 2004
OECD/NA-concept SHA
Source: OECD, Statistik Austria
9,6% of GDP
7,5% of GDP
National costs for health care system
health & sdhealth & sd
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 5
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• While the health care systems core business is to cure, it threatens public health
• Green hospital initiatives can not address this issue sufficently
health & sdhealth & sd
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 6
hospitals & sdhealth & sd environ. efficiency productoutcome quality
3. Specific actions and examples of change in the health-care setting
3.1 Energy efficiency3.2 Green building design3.3 Alternative energy generation3.4 Transportation3.5 Food3.6 Waste3.7 Water
health & sdhealth & sd
2009
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 7
hospitals & sdhealth & sd environ. efficiency productoutcome quality
Energy consumptionin kg oil equivalents per person and year
Average life expectancy and average energy consumption per capita of more than 100 countries for 2003Quelle: Wilkinson Paul, R Smith Kirk, Joffe Michael, Haines Andrew (2007): A global perspective on energy, health effects and injustices. Series Energy and Health 1. The Lancet: 5-18
Life
exp
ecta
ncy
in y
ears
76
In developing countries the more energy consumption the higher the life expectancy
In developed countries energy consumption and life expectancy are independent from each other
environ. efficiency
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 8
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• Global problems require a fundamental change how our societies operate, if we want to avoid unfavourable development of living conditions
• Health systems in developed countries need to change as well
• In addition to energy efficiency of single units e.g. hospitals health systems need to be efficient as a whole – relation of output public health situation to environmental pressure
environ. efficiency
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 9
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• There is very little information available on the health systems environmental efficiency. However, it seems to be that there are many possible path ways – e.g. prevention
• What you don‘t observe you do not react upon
• What then hospitals can do?
environ. efficiency
• Instead of focussing on maximising number of treatments the most efficient improvements of the public health situation are required
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 10
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• Analysing hospitals reveals serious sustainability problems
• Aging society
• More and more is possible
hospitals & sd
• More complex illness patterns• Shift from acute to chronic • Medical science/technical progress
• Financial constraints• Health jobs count already as most burdened
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 11
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• Sustainable solutions have two basic requirements if they want to be successful:
• They need to be scientifically plausbile to be appropriate to reduce global sustainability problems
hospitals & sd
• They need to be attractive and feasible for the ones who have to take action
• Solutions require a co-production from actors form practice and science
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 12
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• Collaboration over years with hospitals and with health promotion researcher
• In varying and complex settings between scientists and actors from hospital association, hospital management, nursing and medical staff
• Key were networking meetings
outcome quality
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 13
hospitals & sdhealth & sd environ. efficiency productoutcome quality
• Outcome quality: To observe and minimize side and long term effects of the core business
• With other words to become more sensitive on issues of problem shifting
outcome quality
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 14
hospitals & sdhealth & sd environ. efficiency productoutcome quality
Environments of the Hospital
Hospital
Economical Sustainability
Ecological Sustainability
SocialSustainability
Grafik-Design: Angy Rattay
A multi-criteria approach for a “Sustainable & HP hospital”(developed and tested in the “Sustainable Hospital Project”, Vienna 2007-10)
Health Promotion
Diagnostic Treatment
outcome quality
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 15
hospitals & sdhealth & sd environ. efficiency productoutcome quality
Environments of the Hospital
Hospital
Economical Sustainability
Ecological Sustainability
SocialSustainability
Grafik-Design: Angy Rattay
By a multi-criteria approach defining a “Sustainable” & Health Promoting hospital(developed and tested in the “Sustainable Hospital Project”, Vienna 2007-10)
Health Promotion
Diagnostic Treatment
These criteria have to be implemented in the hospital by … Explicit policies, targets, action planes,
indicators, … Defined responsibilities (roles, units) Integration in management system (QM,
Balanced Scorecard, … and/or special environmental MS such as EMAS, ISO 14000)
Monitored operational change in core & support processes
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 16
hospitals & sdhealth & sd environ. efficiency productoutcome quality product
http://www.das-nachhaltige-krankenhaus.at/
td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 17
hospitals & sdhealth & sd environ. efficiency productoutcome quality
Thank you for your attention!
Contact:[email protected]@uni-klu.ac.at
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