## 3 Results
### Study of Environmental Efficiency Indices of \"Hospital Activity\"
#### 3.2.2 Environmental Efficiency Index \"Hospital Activity\" per Impact Categories  
Table 5 shows the environmental efficiency indices exclusively for hospital activity for each of the 11 impact categories analysed using the CML-IA methodology.  
In this case, where the environmental efficiency indices typical of hospital activities have been calculated. For the global warming potential index (EEI\({}_{\text{GWP100a}}\)), a value of 1.02 \(\times\) 10\({}^{2}\) was obtained for 2019 and of 1.08 \(\times\) 10\({}^{2}\) for 2020, which means an extra 5.59%. All the environmental aspects analysed have a substantial impact on this index, significantly highlighting the aspects related to consumption of materials and waste generation.  
The consumption of materials in the hospital generates the environmental indices that affect the most in nine of the eleven categories studied. In some indices, such as the EEI\({}_{\text{ADF}}\) and EEI\({}_{\text{HTP}}\), this consumption of materials can account for up to 90% of the total impact. It should be considered that some of these materials consumed in the hospital are toxic, e.g., disinfectants and cleaning products. During 2020, disinfectants were essential products to combat COVID, with the usual consumption rate increasing fourfold. The increase in the use of chemicals for disinfection requires an integrated management from purchase to final disposal, requiring a life cycle assessment of these products in order to select those that are effective and have a lower impact on the environment.  
The results obtained indicate that the environmental impact indices increased in 2020, with the exception of the EEI\({}_{\text{ADF}}\) and EEI\({}_{\text{HTP}}\) indices, which reduced their value by 8.18% and 7.61%, compared to 2019 (see Table 6). This decrease is due to the reduction in the consumption of some materials such as reagents, batteries and toners. Reagents used in hospitals for pathological anatomy processes mainly include alcohol, xylene or formaldehyde. These products, whose consumption has a negative impact on the ADF and TPH categories, are used in the laboratory to analyse and process biopsy, cytology and autopsy samples. These techniques were reduced to a minimum during the pandemic in 2020, with the focus of health activities mainly on COVID-19.  
\begin{table}
\begin{tabular}{c c c c} \hline \hline
**Item** & \begin{tabular}{c} **GEEI** \\ **2019** \\ \end{tabular} & \
\begin{tabular}{c} **GEEI** \\ **2020** \\ \end{tabular} &
\begin{tabular}{c} **\% Variation** \\ \end{tabular} \\ \hline Natural resources & 1.39 \(\times\) 10\({}^{2}\) & 1.52 \(\times\) 10\({}^{2}\) & 9.35\% \\ Medicinal gases & 2.91 \(\times\) 10\({}^{2}\) & 3.74 \(\times\) 10\({}^{2}\) & 28.52\% \\ Wastes & 2.99 \(\times\) 10\({}^{3}\) & 4.43 \(\times\) 10\({}^{3}\) & 48.16\% \\ Discharges & 1.69 \(\times\) 10\({}^{2}\) & 1.90 \(\times\) 10\({}^{2}\) & 12.43\% \\ Consumption of materials & 1.49 \(\times\) 10\({}^{1}\) & 2.36 \(\times\) 10\({}^{1}\) & 58.39\% \\ \hline \hline \end{tabular}
\end{table}
Table 4: Single-value environmental efficiency index hospital activity associated with the hospital activities and services provided in 2019 and 2020.  
The EEI\({}_{\text{ODP}}\) index increased by 28% in 2020 compared to 2019, being the index that increased the most during the pandemic. This result is mainly due to waste generation and the consumption of medical gases.