綠色腎臟——血液透析醫療碳足跡估算

Green Nephrology: Estimating the Carbon Footprint of Hemodialysis

依環境部公告「產品類別規則PCR範本-服務」針對血液透析醫療過程所產生之碳排放量，係自病人進入醫院接受醫療服務起至離開醫院整體過程，進行自主性盤查各項服務之碳排放量。結合PFM與HFMEA模式，首先確認病人進入至離開醫院與治療流程，盤點各項物品，包含耗材、設備、廢棄物等，再依PCR服務類生命週期三步驟：原料取得、服務及廢棄物處理，並參考碳足跡資訊網相關排放係數，以計算公式：碳足跡=活動數據x排放係數，算出產品生命週期各階段碳足跡比例，結果為原料取得6.58%、服務47.17%、廢棄物處理46.26%，自訂碳足跡數據/標示單位為1.41E+01 kgCO2e/人次（4小時）。未來冀望於血液透析治療能邁向落實綠色採購，持續精進低碳服務，期以達成減碳，展開過程可讓同儕醫院參考。

This study estimates the carbon footprint of hemodialysis care using the Environmental Protection Administration’s“Product Category Rules (PCR) Template-Services”. The analysis covers the full patient care cycle-from hospital admission to discharge-through a comprehensive inventory of carbon emissions across all service components. A combined approach using Patient Focus Method (PFM) and Healthcare Failure Modes and Effects Analysis (HFMEA) was employed to map the patient admission, treatment, and discharge processes. Relevant inputs such as consumables, equipment, and waste were systematically inventoried. The carbon footprint was calculated based on the three life cycle stages defined in the PCR: material acquisition, service delivery, and waste management. Emission factors from national carbon footprint databases were applied using the formula: Carbon Footprint=Activity Data×Emission Factor. The carbon footprint distribution was: material acquisition (6.58%), service delivery (47.17%), and waste management (46.26%). The estimated carbon footprint was 14.1 kgCO₂e per patient session (4 hours). Future efforts aim to implement green procurement practices and enhance low-carbon services to reduce emissions. This approach offers a reference for peer institutions seeking to evaluate and reduce their environmental impact.