Francis Vergunst1,2, Helen L Berry3, Jorun Rugkåsa4,5, Tom Burns2, Andrew Molodynski6, Daniel L Maughan2,6. 1. School of Public Health, University of Montréal, Montréal, Canada. 2. Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK. 3. School of Public Health, University of Sydney, Sydney, Australia. 4. Health Services Research Unit, Akershus University Hospital, 1478 Lørenskog, Norway. 5. Centre for Care Research, University College of Southeast Norway, 3900 Porsgrunn, Norway. 6. Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
Abstract
OBJECTIVE: The triple bottom line (TBL) of sustainability is an important emerging conceptual framework which considers the combined economic, environmental and social impacts of an activity. Despite its clear relevance to the healthcare context, it has not yet been applied to the evaluation of a healthcare intervention. The aim of this study was to demonstrate whether doing so is feasible and useful. DESIGN: Secondary data analysis of a 12-month randomized controlled trial. SETTING: Community based mental health care. PARTICIPANTS: Patients with chronic psychotic illnesses (n = 333). INTERVENTION(S): Community treatment orders. MAIN OUTCOME MEASURE(S): Financial and environmental (CO2 equivalent) costs of care, obtained from healthcare service use data, were calculated using publicly available standard costs; social sustainability was assessed using standardized social outcome measures included in the trial data. RESULTS: Standardized costing and CO2e emissions figures were successfully obtained from publicly available data, and social outcomes were available directly from the trial data. CONCLUSIONS: This study demonstrates that TBL assessment can be retrospectively calculated for a healthcare intervention to provide a more complete assessment of the true costs of an intervention. A basic methodology was advanced to demonstrate the feasibility of the approach, although considerable further conceptual and methodological work is needed to develop a generalizable methodology that enables prospective inclusion of a TBL assessment in healthcare evaluations. If achieved, this would represent a significant milestone in the development of more sustainable healthcare services. If increasing the sustainability of healthcare is a priority, then the TBL approach may be a promising way forward.
OBJECTIVE: The triple bottom line (TBL) of sustainability is an important emerging conceptual framework which considers the combined economic, environmental and social impacts of an activity. Despite its clear relevance to the healthcare context, it has not yet been applied to the evaluation of a healthcare intervention. The aim of this study was to demonstrate whether doing so is feasible and useful. DESIGN: Secondary data analysis of a 12-month randomized controlled trial. SETTING: Community based mental health care. PARTICIPANTS: Patients with chronic psychotic illnesses (n = 333). INTERVENTION(S): Community treatment orders. MAIN OUTCOME MEASURE(S): Financial and environmental (CO2 equivalent) costs of care, obtained from healthcare service use data, were calculated using publicly available standard costs; social sustainability was assessed using standardized social outcome measures included in the trial data. RESULTS: Standardized costing and CO2e emissions figures were successfully obtained from publicly available data, and social outcomes were available directly from the trial data. CONCLUSIONS: This study demonstrates that TBL assessment can be retrospectively calculated for a healthcare intervention to provide a more complete assessment of the true costs of an intervention. A basic methodology was advanced to demonstrate the feasibility of the approach, although considerable further conceptual and methodological work is needed to develop a generalizable methodology that enables prospective inclusion of a TBL assessment in healthcare evaluations. If achieved, this would represent a significant milestone in the development of more sustainable healthcare services. If increasing the sustainability of healthcare is a priority, then the TBL approach may be a promising way forward.
Authors: Julia Gonzalez-Holguera; Marie Gaille; Maria Del Rio Carral; Julia Steinberger; Joachim Marti; Nolwenn Bühler; Alain Kaufmann; Luca Chiapperino; Ana Maria Vicedo Cabrera; Joelle Schwarz; Anneliese Depoux; Francesco Panese; Nathalie Chèvre; Nicolas Senn Journal: Front Public Health Date: 2022-07-13
Authors: Augusto da Cunha Reis; Renata Pereira Oliveira; Letícia Ali Figueiredo Ferreira; Cristina Gomes de Souza Journal: Healthcare (Basel) Date: 2021-03-08