A Reproducible Model for Hospital Decarbonization: Integrating Circular Economy Principles in Public Healthcare

Background: Healthcare systems generate nearly 4.4% of global greenhouse gas (GHG) emissions, making the transition toward low-carbon and circular economy models an urgent sustainability challenge. Public hospitals, as large energy and resource consumers, hold a strategic role in mitigating environmental impact and achieving the goals of the European Green Deal. Aim: This study develops and tests a reproducible methodological framework—the HULA Circular Decarbonization Model (HCDM)—designed to integrate circular economy principles into hospital operations and align institutional performance with carbon neutrality targets. Methods: The model was implemented at the Hospital Universitario Lucus Augusti (Spain) following the international GHG Protocol (Scopes 1–3) and ISO 14001 standards. It operationalizes decarbonization through five iterative axes: energy efficiency, clinical emissions control, waste and circular resource management, sustainable mobility, and governance engagement. The process followed a Plan–Do–Check–Act cycle with continuous monitoring of environmental indicators. Results: Between 2021 and 2023, total emissions were reduced by 35%, including a 95% decrease in anesthetic gases and a 17% reduction in plastic waste. The integrated strategy proved technically feasible and economically viable within a publicly funded system, fostering organizational awareness and interdisciplinary participation. Conclusions: The HCDM demonstrates that hospital-level decarbonization can be achieved through structured, low-cost, and replicable interventions. Policy implications: This model offers a transferable framework for public health systems seeking alignment with the European Green Deal, the WHO COP28 Health Report, and the UN 2030 Agenda, advancing the decarbonization of healthcare through circular economy innovation.