"Carbon Footprint and Indirect Costs of Displacement for Advanced Cancer Patients: A Call for Telepalliative Care".

IntroductionProviding palliative care to patients reduces the need for aggressive treatment, hospitalizations, and emergency room visits, thus decreasing the need for patient transportation.ObjectiveTo estimate the amount of carbon emissions and indirect costs related to the transportation of cancer patients receiving palliative care in a tertiary hospital in Brazil.DesignRetrospective cohort study. Setting/participants: patients followed by the palliative care service in a tertiary hospital, with an advanced-stage cancer diagnosis and over 18 years of age, from January 1, 2024 to December 31, 2024.ResultsA total of 327 patients were treated by the Palliative Care Service in 2024, all patients required at least one hospitalization and 215 (65.7%) patients died as a result of the disease in the same year, of which 198 (60.6%) died during hospitalization. An estimated 105,310.4 kg of CO2 emissions were generated, equivalent to the carbon sequestration of approximately 1,700 tree seedlings grown for 10 years. The time involved in travel was 6,727 hours, equivalent to 280 days. The estimated indirect transportation costs ranged from US$184,293 to US$263,276.ConclusionsThe integration of telemedicine into palliative care services is an urgent planetary health strategy and a means of financial sustainability for patients, families, and public or private health systems.