Hadi Keshavarz

Background: The economic toll of health issues related to carbon emissions is substantial, accounting for a significant portion of national healthcare expenditures. This research addresses the lack of studies on healthcare service quality and the local effects of carbon emissions. Methods: This study employed spatial econometrics to investigate the direct and indirect effects of carbon emissions on the quality of health services across Iranian provinces from 2011 to 2021. This method was chosen for its ability to capture both within-province and between-province effects, which is crucial for developing robust health policies. The researchers created a comprehensive index for health service quality, incorporating input, output, and overall index, using the entropy method. Results: The findings indicate that CO₂ pollutants negatively impact both the output and the overall health service quality index. Economic growth demonstrated a positive direct impact and a negative indirect (spillover) effect on both dependent variables. The divergent indicators of direct and geographical consequences of per capita output growth imply a multifaceted link between the two. This indicates that economic affluence in one province directly enhances the quality of its healthcare services. The quality of health services in nearby regions may suffer as a result. Moreover, the input index demonstrates a substantial positive effect, while inflation and inequality exhibit a detrimental effect on the quality of health services. Conclusion: The study’s findings suggest that improving the quality of health services requires a multifaceted approach, encompassing not only direct healthcare investments but also broader economic and environmental considerations.