## 4 Discussion  
This article analyses the effect of the COVID-19 coronavirus crisis on the different environmental efficiency indices studied in the hospital sector. The results were obtained by taking a regional hospital as a case of focus, analysing its hospital activities during 2019 and 2020 and evaluating the environmental impact of these activities. The aim of this research has been to analyse the changes produced by the pandemic in the regular activities of the hospital and to determine the environmental impact, which allows reflecting on the exceptional situation generated. The life cycle assessment methodology was used as the basis for the development of this research, by analysing the inventory, compiling the data and comparing the environmental impacts during the pandemic, in 2019 and 2020. Hospital activity during the COVID-19 pandemic focused on the care of patients infected with the coronavirus, while continuing to care for other patients. This article \begin{table}
\begin{tabular}{c c c c} \hline \hline \multirow{2}{*}{**Item**} & \multicolumn{2}{c}{**Total**} & \multirow{2}{*}{**\% Variation**} \\ \cline{2-2} \cline{4-4}  & & **2019** & & **2020** \\ \hline EEI\({}_{\text{ADP}}\) & \(9.11\times 10^{-5}\) & \(1.02\times 10^{-4}\) & \(12.32\%\) \\ \hline EEI\({}_{\text{ADP}}\) & \(2.67\times 10^{3}\) & \(2.45\times 10^{3}\) & \(-8.18\%\) \\ \hline EEI\({}_{\text{COVIDP}}\) & \(1.02\times 10^{2}\) & \(1.08\times 10^{2}\) & \(5.49\%\) \\ \hline EEI\({}_{\text{COP}}\) & \(3.28\times 10^{-6}\) & \(4.19\times 10^{-6}\) & \(27.99\%\) \\ \hline EEI\({}_{\text{HTP}}\) & \(9.20\times 10^{1}\) & \(8.50\times 10^{4}\) & \(-7.61\%\) \\ \hline EEI\({}_{\text{WAE}}\) & \(3.81\times 10^{1}\) & \(4.36\times 10^{1}\) & \(14.60\%\) \\ \hline EEI\({}_{\text{MEDP}}\) & \(1.00\times 10^{5}\) & \(1.01\times 10^{5}\) & \(1.07\%\) \\ \hline EEI\({}_{\text{IE}}\) & \(2.43\times 10^{-1}\) & \(2.86\times 10^{-1}\) & \(17.43\%\) \\ \hline EEI\({}_{\text{ICCP}}\) & \(3.21\times 10^{-2}\) & \(3.70\times 10^{-2}\) & \(15.39\%\) \\ \hline EEI\({}_{\text{AP}}\) & \(3.28\times 10^{-1}\) & \(3.38\times 10^{-1}\) & \(3.20\%\) \\ \hline EEI\({}_{\text{ETF}}\) & \(1.43\times 10^{-1}\) & \(1.67\times 10^{-1}\) & \(16.59\%\) \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Total global environmental efficiency indices classified by impact category without transport (2019–2020). \begin{table}
\begin{tabular}{c c c c c c c c c c c c c c c} \hline \hline \multirow{2}{*}{**Item**} & \multicolumn{3}{c}{**National Resources**} & \multicolumn{3}{c}{**Medical Crime**} & \multicolumn{3}{c}{**White Production**} & \multicolumn{3}{c}{**White Disposal**} & \multicolumn{3}{c}{**Consumption of Materials**} \\ \cline{2-19}  & **2019** & **2020** & \% & **2019** & **2020** & \% & **2019** & **2020** & \% & **2019** & **2020** & \% & **2019** & **2020** & \% \\ \hline EEI\({}_{\text{ADP}}\) & \(44.2\) & \(4.68\) & \(4.95\) & \(1.71\) & \(2.19\) & \(2 shows the effect this change has had on the normal functioning of hospital activities from the perspective of its environmental impact. For this purpose, the life cycle assessment tool was used, as it provides a detailed analysis of the environmental impact of any process and serves as a reference for the development of strategies and decision-making, considering its environmental implications. On the other hand, the pandemic provided a number of lessons learned for the future in terms of care practices, which also contributed to improving the environmental impact of hospitals. Projects that had been worked on for a long time, such as telemedicine and telecare, became standard practice in healthcare within a few weeks, reducing bureaucracy and streamlining care in activities such as the renewal of electronic prescriptions. Faced with insufficient resources and infrastructure, hospitals were forced to improve their care processes, allocating resources according to risk, redesigning services and streamlining the patient discharge process.