{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:55:08Z","timestamp":1777683308548,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,8,14]],"date-time":"2013-08-14T00:00:00Z","timestamp":1376438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Health Serv Res Policy"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Health services contribute significantly to greenhouse gas emissions. New models of delivering care closer to patients have the potential to reduce travelling and associated emissions. We aimed to compare the emissions of patients attending a teleconsultation \u2013 an outpatient appointment using video-conferencing equipment \u2013 with those of patients attending a face-to-face appointment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We estimated the total distances travelled and the direct and indirect greenhouse gas emissions for 20,824 teleconsultations performed between 2004 and 2011 in Alentejo, a Portuguese region. These were compared to the distances and emissions that would have resulted if teleconsultations were not available and patients had to attend face-to-face outpatient appointments. Estimates were calculated using survey data on mode of transport, and national aggregate data for car engine size and fuel. A sensitivity analysis using the lower and upper quartiles for survey distances was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Teleconsultations led to reductions in distances and emissions of 95%. 2,313,819\u2009km of travelling and 455 tonnes of greenhouse gas emissions were avoided (22\u2009kg of carbon dioxide equivalent per patient). The incorporation of modes of transport and car engine size and fuel in the analysis led to emission estimates which were 12% smaller than those assuming all patients used an average car.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The availability of remote care services can significantly reduce road travel and associated emissions. At a time when many countries are committed to reducing their carbon footprint, it is desirable to explore how these reductions could be incorporated into technology assessments and economic evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1355819613492717","type":"journal-article","created":{"date-parts":[[2013,8,15]],"date-time":"2013-08-15T06:34:15Z","timestamp":1376548455000},"page":"209-214","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":53,"title":["Teleconsultations reduce greenhouse gas emissions"],"prefix":"10.1177","volume":"18","author":[{"given":"Tiago Cravo","family":"Oliveira","sequence":"first","affiliation":[{"name":"PhD Student, Imperial College Business School, Imperial College London, UK"}]},{"given":"James","family":"Barlow","sequence":"additional","affiliation":[{"name":"Professor of Technology and Innovation Management, Imperial College Business School, Imperial College London, UK"}]},{"given":"Lu\u00eds","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Director of Alentejo Telemedicine Programme, Administra\u00e7\u00e3o Regional de Sa\u00fade do Alentejo, I.P. Portugal"}]},{"given":"Steffen","family":"Bayer","sequence":"additional","affiliation":[{"name":"Research Fellow, Imperial College Business School, Imperial College London, UK"}]}],"member":"179","published-online":{"date-parts":[[2013,8,14]]},"reference":[{"key":"bibr1-1355819613492717","volume-title":"Sustainability in the NHS: health check 2012","author":"NHS Sustainable Development Unit","year":"2012"},{"key":"bibr2-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2010.010142"},{"key":"bibr3-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39538.375706.DB"},{"key":"bibr4-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2009.9945"},{"key":"bibr5-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2010.0057"},{"key":"bibr6-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1258\/jtt.2009.003010"},{"key":"bibr7-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1258\/jtt.2009.003004"},{"key":"bibr8-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2009.008154"},{"key":"bibr9-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60766-1"},{"key":"bibr10-1355819613492717","volume-title":"Estat\u00edsticas dos transportes 2011","author":"Instituto Nacional de Estat\u00edstica (INE)","year":"2012"},{"key":"bibr11-1355819613492717","volume-title":"O com\u00e9rcio e a ind\u00fastria autom\u00f3vel em Portugal","author":"Associa\u00e7\u00e3o Autom\u00f3vel de Portugal (ACAP)","year":"2008"},{"key":"bibr12-1355819613492717","volume-title":"2012 Guidelines to Defra\/DECC\u2019s GHG conversion factors for company reporting","author":"AEA for Defra and DECC","year":"2012"},{"key":"bibr13-1355819613492717","volume-title":"European motor vehicle parc 2008","author":"Asociaci\u00f3n Espa\u00f1ola de Fabricantes de Autom\u00f3viles y Camiones (ANFAC)","year":"2010"},{"key":"bibr14-1355819613492717","volume-title":"Average carbon dioxide emissions per km from new passenger cars (code: tsdtr450)","author":"Eurostat","year":"2013"},{"key":"bibr15-1355819613492717","volume-title":"Patient travel assistance programs in Ontario \u2013 findings of a review of the northern health travel grant program and cancer care Ontario radiation re-referral policy","author":"Ministry of Health and Long-Term Care","year":"2000"},{"key":"bibr16-1355819613492717","volume-title":"Carbon 2012","author":"Heimdal C","year":"2012"},{"key":"bibr17-1355819613492717","unstructured":"Clark P and Farchy J. Carbon prices tumble to record low.\n                      Financial Times\n                      , http:\/\/www.ft.com\/cms\/s\/0\/22951a04-d0f8-11e1-8957-00144feabdc0.html#axzz2CrQxgH7X (2012, accessed 14 January 2013)."},{"key":"bibr18-1355819613492717","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2008.008147"}],"container-title":["Journal of Health Services Research &amp; Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1355819613492717","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1355819613492717","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1355819613492717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:45:46Z","timestamp":1777452346000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1355819613492717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,14]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1177\/1355819613492717"],"URL":"https:\/\/doi.org\/10.1177\/1355819613492717","relation":{},"ISSN":["1355-8196","1758-1060"],"issn-type":[{"value":"1355-8196","type":"print"},{"value":"1758-1060","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8,14]]}}}