Conectar
To estimate condition-specific patient travel distances and associated carbon emissions across common chronic diseases in routine National Health Service (NHS) care, and to assess the potential carbon savings of modal shifts in transportation.
Retrospective population-based cohort study.
NHS Greater Glasgow and Clyde, Scotland.
6599 patients aged 50–55 years at diagnosis, including cardiovascular disease (n=1711), epilepsy (n=1044), cancer (n=716), rheumatoid arthritis (RA; n=172) and a matched control group based on age, sex and area-level deprivation (n=2956).
Annual home-to-clinic distances and associated carbon emissions modelled under four transport modes (petrol car, electric car, bus, train) across five time points: 2-year prediagnosis, diagnosis year and 2-year postdiagnosis.
Mean annual travel distances to hospital varied by condition and peaked at diagnosis. Patients with cancer had the highest travel distances (161 km/patient/year for men; 139 km/patient/year for women), followed by RA (approximately 78 km/patient/year). The matched control group travelled 2/patient/year to 8.0 kg CO2/patient/year. Bus travel resulted in intermediate emissions, estimated between 10.5 and 8.0 kg CO2/patient. When travel was modelled using electric vehicles, emissions dropped between 3.5 and 2.7 kg for all conditions. Train travel produced similarly low emissions. Reducing petrol car travel from 100% to 60% lowered emissions up to 6.6 kg CO2/patient.
Condition-specific estimates of healthcare-related travel emissions provide baseline understanding of the opportunities and challenges for decarbonising healthcare. Emission reduction is most achievable through modal shift, yet such shifts depend on factors beyond NHS control—such as transport infrastructure, digital access and social equity. Multisectoral strategies, including targeted telemedicine and integrated transport and urban planning, are critical to achieving net-zero healthcare while maintaining equitable access to care.
To explore adult inpatients' perceptions, understanding and preferences regarding the term ‘malnutrition’ and to identify the terms that adult inpatients report are used by themselves and health workers to describe malnutrition.
This qualitative study was conducted using data collected for a separate qualitative study that investigated factors that influence the dietary intake of long-stay, acute adult inpatients.
Semi-structured interviews were conducted with a purposive sample of current inpatients. Data were analysed using inductive content analysis.
Nineteen interviews were included (mean age 64 years (standard deviation ±17), 10 female (53%), 12 malnourished (63%)). Four categories were identified. ‘Variation in patients' recognition of malnutrition’ represents the differing abilities of patients to understand and identify with the term ‘malnutrition’. ‘Recognising individuals' needs and preferences’ highlights patients' varying beliefs regarding whether ‘malnutrition’ is or is not an appropriate term and participants' suggestion that health workers should tailor the term used to each patient. ‘Inconsistencies in health workers' and patients' practice regarding malnutrition terminology’ encapsulates the multiple terms that were used to describe malnutrition by health workers and patients. ‘Importance of malnutrition education’ summarises patients' views that health workers should provide patient education on malnutrition prevention, management and complications.
Findings highlight variations in patients' perceptions and understanding of the term ‘malnutrition’ and differences in the terms used by patients and health workers to describe malnutrition.
The terminology used by health workers to describe malnutrition risk or malnutrition to their patients can influence patients' recognition of their nutritional status and thus the multidisciplinary management of the condition. To ensure that patients receive information about their malnutrition risk or diagnosis in a way that meets their needs, health workers' practices must be revised. To do this, it is imperative to conduct further collaborative research with patients and health workers to identify optimum terms for ‘malnutrition’ and how health workers should communicate this to patients.
There is a disparity in patients' perceptions, understanding and preferences for the term ‘malnutrition’ and there are inconsistencies in how health workers communicate malnutrition to patients. To support patients' recognition and understanding of their nutritional status, it is imperative for health workers to consider how they discuss malnutrition with patients.
Adheres to the Consolidated Criteria for Reporting Qualitative Research (Tong et al., 2007).
No Patient or Public Contribution.
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