Frequently, public service deliverance has adverse substantive impacts on the environment. Wolf’s theory of non-market failure views these impacts as derived externalities , while Moore’s theory of public value invites to view them as resulting from a partial or biased consideration of the public-value dimensions by the service providers. In the case of healthcare, such environmental damages also have a boomerang effect, so they often affect people’s health. However, the carbon footprint (CF) of public hospitals remains understudied in many countries. More specifically, very little research focuses on the evolution of CF at the organizational (hospital) level under a systemic shock like the last pandemic. To our knowledge, this is the first study that combines CF computation and data envelopment analysis (DEA) to investigate the environmental efficiency of public hospitals before and during the pandemic. We compare a big and purely public hospital (HA) with a smaller public hospital managed through a public-private partnership (HB). In both hospitals, the main sources of emissions were electricity consumption (55.89% in HA and 48.41% in HB) and natural gas (28.89% in HA and 26.41% in HB). During the pandemic, the two hospitals achieved higher scores in our DEA-based environmental efficiency measure, even when a standard general activity volume indicator is added as input. Our results portray 2020 as the abrupt shock year and 2021 as the year of a shock attenuation (HA) or partial return to normalcy (HB).
Vidal-Camiña et al. (Thu,) studied this question.