Variations of nitrous oxide procurement per public hospital bed between Australian states and territories: A cross-sectional analysis

We aimed to identify variations in nitrous oxide (N₂O) procurement between Australian states and territories per public hospital bed by undertaking a cross-sectional analysis of N₂O procurement data for all Australian public hospitals from 1 January 2017 to 30 June 2022. Data were obtained from state and territory departments of health. All Australian public hospitals across six states and two territories were included. We obtained N₂O procurement data from Department of Health representatives from all states and territories, accounting for all 697 Australian public hospitals and four public dental hospitals. The main outcome measured in this study was N₂O procurement per public hospital bed by state or territory. Across the 5 years (1 January 2017 to 30 June 2022) an average of 242,054 (standard deviation (SD) 16,222) kg of N₂O, equivalent to 64,144 (4299) tonnes of carbon dioxide emissions (CO₂e), were procured per annum. CO₂e emissions from N₂O purchase varied more than threefold per public hospital bed between different states/territories (0.47-1.48 CO₂e tonnes per hospital bed). There were significant variations in N₂O procurement between Australian states and territories when adjusted for public hospital bed numbers. Further analysis of this variation to determine cause and to guide mitigation interventions is therefore warranted.