Toward sustainable healthcare: Circular economy models in hospital operations and waste management

The integration of circular economy (CE) principles into hospital operations, focusing on environmental, economic, and operational outcomes, represents a pressing challenge within the current healthcare system. This study systematically reviewed 11 peer-reviewed studies selected from 5976 articles published between 2014 and 2025 following the PRISMA 2020 guidelines, including life cycle assessment (LCA) and material flow analysis (MFA) investigations. Evidence consistently indicates that reusable and repairable medical devices significantly outperform single-use alternatives, achieving up to a 76% reduction in carbon emissions and 50% cost savings. MFA studies revealed that single-use plastics, particularly gloves, gowns, and packaging, constitute more than 70% of hospital waste, highlighting critical targets for CE intervention. Furthermore, integrated waste management systems that combine segregation and recycling demonstrate superior environmental performance compared to incineration-dominated approaches. Despite these clear benefits, barriers such as regulatory inertia, limited sterilization infrastructure, and procurement models favoring disposables impede the adoption of CEs. Conversely, enabling factors include green procurement policies, digital tracking tools, and leadership-driven sustainability programs. Major research gaps remain regarding CE implementation in low- and middle-income countries, standardized LCA methodologies, and behavioral factors that influence adoption. The findings underscore the transformative potential of CE strategies such as reuse, repair, remanufacturing, and resource recovery in decarbonizing healthcare while maintaining safety and efficiency. This analysis evaluates Scope 1 (direct), 2 (indirect), and 3 (supply-chain) emissions reduction strategies. Integrating CE metrics into procurement and policy frameworks could make healthcare a sustainability leader.