The healthcare sector accounts for five percent of Germany's total raw material consumption – this is about 107 million tonnes, which has increased by about 80 percent since the mid-1990s and is likely to continue to increase. In addition to the high cost of raw materials, high resource consumption is accelerating climate change, and the healthcare system is more strongly affected by climate change impacts than other sectors, for instance, through heatwaves and new infectious diseases. Crises such as the current corona pandemic could further increase resource consumption and exacerbate the problem.

For these reasons, it is worth improving resource efficiency in the health sector without jeopardizing the quality of care or its cost-effectiveness. On behalf of the German Federal Ministry for the Environment and the Federal Environment Agency, the Fraunhofer Institute for Systems and Innovation Research ISI has quantified the sector’s resource consumption and identified priority fields for action. The researchers then explored existing approaches. With the involvement of healthcare and resource conservation experts, they developed recommendations for action concerning chemicals, medical devices, construction, and food and beverages.

In the use of chemicals, especially pharmaceuticals, raw materials can be saved through resource-conserving production as well as changes in the care process, for example:

• prioritizing resource-conserving and biodegradable substances in production, and promoting research in this field
  
• strengthening production in Germany in order to influence production conditions and avoid supply bottlenecks
  
• demand-oriented sizing of packages and adjusted expiry dates to reduce pharmaceutical waste
  
• greater involvement of pharmacists in medication management
  
• promoting personalized treatment and joint decision-making with patients to improve compliance and effectiveness

For medical devices (dressings, medical aids, surgical items, implants, medical technology), resources can be saved through product-specific measures and modified processes, for example:

• extending product life span by designing modular appliances that enable the exchange of components
  
• intensifying the use of devices through sharing and operator models instead of the sale of new devices
• reusing simple medical devices and recycling materials
  
• incorporating environmental criteria into purchasing decisions

A great deal of knowledge already exists about resource-conserving construction, but according to the study, this needs to be made more user-friendly and additional incentives are required. Examples include:

• providing user-friendly information
  
• promoting education and training programs for resource-efficient construction
  
• strengthening networking between federal, state and local government as well as setting up expert groups to share and exchange knowledge
  
• promoting sustainable construction in the healthcare sector through suitable incentives
• adapting legal framework conditions and standards, for example, for fire protection and the use of recycled concrete

Ways to reduce resource consumption for the supply of food and beverages include less waste and packaging and resource-conserving products. This can be achieved, among other things, by:

• promoting synergies between resource-saving catering and healthy food, for example by using plant-based products
  
• sharing experiences of successful examples in inpatient health care
  
• introducing quotas for resource-saving food and reusable packaging
  
• subsidizing investments in modern kitchens for hospitals and care homes
  
• introducing daily rates in healthcare facilities that cover the cost of seasonal and regional fresh produce

In addition to improving resource conservation in the treatment of illnesses, the authors see significant potential in prevention: sports, nutrition and psychotherapy can help to keep people fit and healthy and thus reduce the need for curative health services. Prevention should therefore be prioritized by the healthcare system and policymakers.

Something else is also needed across all the fields of action: raising the awareness and motivation of stakeholders in the health sector. Dr. Katrin Ostertag is head of the Competence Center Sustainability and Infrastructure Systems at Fraunhofer ISI. Together with Dr. Tanja Bratan, head of the Business Unit Innovations in the Health System, she was responsible for the study of resource conservation in the healthcare sector. In the process, she discovered “that the topic of resource conservation plays rather a minor role for most of the stakeholders in the German healthcare system. They have other priorities: economic constraints, time pressure, staff shortages. These are all important factors, but the topic of resource conservation needs to be higher on the political agenda because climate change, which is partly caused by high resource consumption, has serious impacts on the health of the population.”

The researchers recommend that, as a first step, policymakers as well as stakeholders from the healthcare system, resource conservation and civil society establish a round table as an interdepartmental activity in order to develop an overall strategy for greater resource efficiency in healthcare.  

The Fraunhofer Institute for Systems and Innovation Research ISI analyzes the origins and impacts of innovations. We research the short- and long-term developments of innovation processes and the impacts of new technologies and services on society. On this basis, we are able to provide our clients from industry, politics and science with recommendations for action and perspectives for key decisions. Our expertise is founded on our scientific competence as well as an interdisciplinary and systemic research approach.