The energy burden of care: Insights from a regional survey in Italian hospitals

Introduction Hospitals are among the most energy-intensive public infrastructures due to their continuous operations and complex systems. Despite the strategic importance of energy management in healthcare, detailed benchmarks for hospital energy costs remain limited in Italy.Methods This study analyzes energy-related facility management expenditures in 27 public hospitals in Lombardy between 2019 and 2022. Data were collected via a structured survey, focusing on electricity and heating expenditures. Parametric values were calculated in /sqm and hospitals were classified by complexity (Basic, DEA I, DEA II).Results The results reveal that energy costs represent approximately 48% of total facility management expenses. Over the 4-year period, total energy expenditures rose by 51.22%, with the most significant increases in 2021-2022. Parametric values varied by hospital type: from 71.64/sqm in Basic Hospitals to 101.65/sqm in DEA II. Though newer buildings generally showed lower energy costs, building age alone did not fully explain cost variability.Conclusions The study provides a first benchmarking effort on hospital energy costs in the Italian context. The findings highlight the need for energy monitoring, retrofitting, and the adoption of efficiency-oriented management strategies, providing actionable insights for infrastructure planning and healthcare policy.