Page 1 of 11

DOI: 10.14738/aivp.91.9106

Publication Date: 20th November, 2020

URL: http://dx.doi.org/10.14738/aivp.91.9106

Applications of Distributed Electricity Generation Systems in

Hospitals

John Vourdoubas

Consultant Engineer

vourhome@otenet.gr

ABSTRACT

Distributed energy generation systems have currently increasing applications in many sectors due to

the resulted benefits. In the current study the application of distributed electricity generation systems

in hospitals is investigated. The energy consumption in hospitals in many countries varies between

254.9 KWh/m2 and 738.5 KWh/m2

. Various distributed energy generation systems have been

examined and their characteristics are mentioned. The fuels used in them are either natural gas or

renewable energy sources. Some energy systems generate only power while others co-generate heat

and power. Our results indicate that various distributed generation systems are mature, reliable and

cost-effective and they are currently used in health care centers. Others could be used in the future

after improvements in their technology and reduction of their cost. Use of the abovementioned

energy systems in hospitals would result in the increase of their sustainability, decrease of

conventional fuels used as well as in lower carbon emissions into the atmosphere. Taking into account

that the use of unconventional green energy sources in hospitals is currently rather limited our results

could trigger the increasing use of low or zero carbon emission energy sources in them contributing in

the global effort for climate change mitigation.

Keywords: co-generation of heat and power; distributed electricity generation; energy consumption;

fuel cells; hospitals; renewable energies.

1 Introduction

Distributed energy generation systems have many advantages and they find increasing applications in

many sectors. They often use renewable energies like solar and wind energy or very efficient energy

technologies like heat and power co-generation systems. Their advantages include higher grid

stability, increase of electricity security, increase of locally available renewable energies use, lower

use of fossil fuels and lower carbon emissions into the atmosphere. The majority of the hospitals are

currently using conventional energy sources and fuels like grid electricity and heating oil or natural

gas. Our current research is focused in the application of various distributed generation technologies

in hospitals. Some energy systems are already used in them while others could be used in the future

under specific conditions. The increasing use of distributed electricity generation systems in health

care centers is desirable, feasible and it is promoted with public policies for many environmental,

economic and social reasons. Our research is important since it offers a review of the distributed

electricity generation systems which could be used in hospitals. Some of these systems are mature,

reliable, cost-effective and they are already used in them. Others need technological improvements

in order to be used in the future while others could be used only under specific conditions. Since

hospitals are large electricity consumers the use of the abovementioned sustainable energy systems

in them would result in the reduction of their carbon footprint due to energy use. Additionally the use

Page 2 of 11

European Journal of Applied Sciences, Volume 9 No. 1, February 2021

Services for Science and Education, United Kingdom 11

of these energy technologies in hospitals will assist them to contribute in the mitigation of climate

change which consists of the major environmental problem for humanity.

2 Literature survey

2.1 Energy consumption in hospitals

Gonzalez Gonzalez et al [1] have evaluated the energy consumption in German hospitals. The authors

mentioned that during 2005-2015 twenty three (23) public hospitals in Germany were audited

regarding their energy behavior. Their average annual energy consumption was estimated at 270

KWh/m2

, 14,370 KWh/worker and 23,410 KWh/bed. Hu et al [2] have estimated the energy

consumption and the energy cost in a large hospital in Taipei, Taiwan. The authors stated that its

annual energy consumption was at 259.45 KWh/m2

. They also mentioned that its highest monthly

energy consumption was recorded in July at 25.5 KWh/m2 while more than 50% of the electricity was

consumed in air-conditioning of the hospital. Garcia-Sanz-Calcedo et al [3] have estimated the energy

consumption in Spanish hospitals. The authors studied the energy behavior of eighteen (18) Spanish

hospitals during 2005-2014. They stated that their average annual energy consumption was at 270

KWh/m2

, 10,000 KWh/employee and 35,000 KWh/bed. Biglia et al [4] have studied the energy

behavior in Brotzu hospital in Cagliari, Italy. The authors estimated its annual energy consumption at

254.9 KWh/m2

. They also mentioned that electricity had a share at 57% in the final energy use while

fuel oil at 43%. Bawaneh et al [5] have estimated the energy consumption in healthcare facilities in

USA. The authors stated that the annual energy consumption in U.S.A. hospitals varies between 640.7

KWh/m2 (in hot zones) to 781.1 KWh/m2 (in cold zones) with an average value at 738.5 KWh/m2

. They

also mentioned that their energy consumption was approximately 2.6 times higher than in other

commercial buildings while it was also higher than in European hospitals. Jiang et al [6] have

estimated the energy consumption and carbon emissions of hospitals in Tianjin, China. The authors

have audited twenty two (22) hospitals in Tianjin estimating their average annual energy consumption

at 348 KWh/m2 and their average annual CO2 emissions at 157kgCO2/m2

. They also mentioned that

the heating system consumed the highest amount of energy (42.12%) followed by the cooling system

(6.78%) the medical system (4.98%) and the lighting system (3.63%). Vourdoubas [7] estimated the

energy consumption and the CO2 emissions in Venizelio hospital located in Crete, Greece with capacity

400 beds. The author estimated its annual energy consumption at 280.4 KWh/m2 and its annual CO2

emissions at 168kgCO2/m2

. He also mentioned that electricity had a share at 72.11% in the final energy

use while heating oil at 27.89%. Santamouris et al [8] have studied the energy performance and

energy conservation in Hellenic health care buildings. The authors studied the energy behavior of 30

health care buildings calculating the annual energy consumption in Hellenic hospitals at 407 KWh/m2

.

They also mentioned that 73.4% of the overall energy consumption was used for heating while they

estimated that their energy consumption could be reduced by 20% with energy conservation

measures.

2.2 Distributed electricity generation systems

Huang et al [9] have studied the fuel cell technology for distributed generation. The authors

mentioned that fuel cells consist of a promising and competent power generation technology which

could be used in distributed generation systems. They also stated that fuel cells have various

advantages compared with other energy systems including high energy conversion, possibility for co- generation, low emissions when using H2 as fuel, modularity, quick installation and absence of moving

parts. Yekini Subern et al [10] have reviewed the renewable energy distributed generation in rural

villages. The authors stated that the renewable energy resources which could be used for electricity

Page 3 of 11

John Vourdoubas; Applications of Distributed Electricity Generation Systems in Hospitals. European Journal of

Applied Sciences, Volume 9 No 1, February 2021; pp:10-20

URL: http://dx.doi.org/10.14738/aivp.91.9106 12

generation include solar energy, wind energy, bio-energy and small hydropower. They also mentioned

that micro-grid power systems based on a large number of reliable small renewable energy systems,

which are properly managed, could be reliable and effective like larger grid systems. Hidayatullah et

al [11] have analyzed distribution generation systems and smart grid technologies. The authors stated

that current problems including climate change, increasing energy prices, energy security and energy

efficiency require changes in the way that energy is produced, transmitted and utilized. They also

described various distribution generated systems including solar-PVs, wind turbines, micro-gas

turbines and fuel cells. Hansen et al [12] have studied the economic performance of various

distributed generation technologies in rural areas in India. The authors mentioned that renewable

energy and small scale distributed generation technologies have the potential to provide electricity to

nearly 2 billion people who currently have not access to grid electricity. They found out that distributed

generation systems can provide electricity in a cost-effective way in rural areas if local energy

resources like solar energy, wind energy and biomass are adequate. Vourdoubas [13] studied the

sustainable energy technologies used in buildings in Mediterranean basin. The author stated that for

electricity generation in buildings the sustainable energy technologies which could be used include: a)

Solar thermal systems with parabolic collectors and Sterling engine, b) Solar-PV systems, c) Wind

turbines, and d) Co-generation of heat and power systems. U.S.A. Environmental Protection Agency

[14] has reported on distributed generation of electricity. The report mentioned various distributed

generation systems which are used in the residential the commercial and the industrial sector. It is

also stated that distributed generation technologies can reduce the environmental impacts of

centralized electricity generation while they can also result in negative environmental impacts mainly

when they are combined with combustion processes. Purchala et al [15] have studied the distributed

generation and the grid integration issues. The authors mentioned that although distributed

generation is conceived as a small scale electricity generation there is no consensus among

international organizations regarding the capacity of these power systems. They also stated that

during the last years the concept of many small scale conventional or renewable energy sources

generating electricity dispersed into the grid has become popular since those systems have various

advantages as well as drawbacks. Paliwal et al [16] have studied the distributed generation

technologies and their integration into the grid. The authors mentioned that integrating renewable

energies, based on distributed generators, into the grid could be a solution to current problems

including depletion of fossil fuels, mitigation of climate change and increase of energy security. They

also stated that integration of distributed generators into the grid should take into account the fuel

and technology used, the operating characteristics of the grid as well as the economics of the energy

generation. Moroni et al [17] have analyzed the ideas of distributed generation and energy

communities which are very popular among politicians and scholars. The authors stated that although

there is global consensus for those two ideas there are profound differences between them. They

proposed that different policies based on their differences are required for the promotion of energy

communities and the distributed generation systems. Ali et al [18] have studied the current micro- grid policies in EU, USA and China. The authors mentioned that distributed generation systems utilizing

renewable energies are desirable in achieving lower fossil fuels use, lower carbon emissions, higher

energy security and increased electricity demand. They also stated that effective micro-grid policy

instruments are necessary for successful integration of distributed generation systems using

renewable energies in the operation, control and stability of micro-grids.

Page 4 of 11

European Journal of Applied Sciences, Volume 9 No. 1, February 2021

Services for Science and Education, United Kingdom 13

2.3 Use of sustainable energy systems in hospitals

Tahboub et al [19] have investigated the possibility of using clean energy technologies in Al-Ahli

hospital in Palestine with capacity 500 beds. The authors estimated that its annual energy

consumption could be reduced by 30-40% with the use of a wind turbine with capacity 750 KW in the

hospital. Alternatively they proposed that using hybrid wind energy – solar energy system having a

smaller wind turbine capacity at 330 KW could also achieve the same target of the overall energy

reduction in the hospital by 30-40 %. Franco et al [20] have reviewed the use of various sustainable

energy technologies in hospitals located in developing countries which are often lacking reliable and

affordable energy. The authors have examined the use of solar energy, wind energy, co-generation of

heat and power, small hydroelectricity combined with electricity storage systems based on batteries.

They stated that the use of solar and wind energy, which are intermittent energy sources, should be

combined with electric batteries in order to provide continuous and reliable electricity in the hospitals.

Gupta et al [21] have studied the use of solar and wind energy in hospitals focused in a large hospital

in New Delhi, India. The authors investigated the use of solar thermal systems, solar-PV systems and

small wind turbines placed on the rooftop of the buildings. They stated that the use of wind turbines

was not attractive, due to low wind speeds at the specific site, while the use of solar thermal systems

for heat production was a viable solution. Results from a European project regarding zero carbon

emission hospitals due to energy use have been published [22]. It is mentioned that promotion of

renewable energies in E.U. hospitals has not received so far high priority. It is also stated that among

various renewable energy sources biomass is considered as the best option to achieve 50%

penetration of renewable energies in hospitals. Kantola et al [23] have compared the use of

renewable energies with conventional energy sources in Finnish hospitals. The authors mentioned

that the most commonly used energy sources, district heating and grid electricity, were the most

expensive and polluting solutions. They stated that, with reference Espoo hospital, the most

affordable solutions were biogas energy, wood chip heating and ground source heat pumps heating.

They concluded that biogas energy was by far the most affordable solution while solar electricity was

the most expensive technology. Mat Isa et al [24] have studied a combined heat and power

generation system providing energy in a Malaysia hospital. The authors assessed a hybrid co- generation system consisted of a solar-PV, a fuel cell and a battery generating heat and electricity for

the hospital. They stated that the hybrid co-generation system had lower levelized cost of electricity

and less CO2 emissions compared with conventional energy technologies used in hospitals.

Buonomano et al [25] have studied a novel renewable poly-generation system providing electricity,

heat and cooling in an Italian hospital located in Naples. The poly-generation system was consisted of

concentrated photovoltaic thermal collectors combined with an absorption chiller while the hospital

was equipped with a gas turbine co-generation system. The authors mentioned that, according to

their simulation, the system was profitable with pay-back period at 12 years without any public

subsidies. Teke et al [26] have proposed a methodology for sizing co-generation and tri-generation

energy systems in hospitals. The authors mentioned that the use of combined cooling, heat and power

tri-generation systems or heat and power co-generation systems in hospitals, with overall efficiency

at around 80%, has many benefits. They estimated that the use of these high-efficiency energy

systems in a medium size hospital could reduce its energy consumption by 19-20%. A study concerning

the use of renewable energies in rural health care clinics has been published by NREL [27]. The report

mentioned the most promising renewable energy technologies covering the electricity needs in rural

health care facilities. Among them the most appropriate is the solar-PV technology which is often used

combined with diesel generators and batteries. Wind turbines could be also used when the average

annual wind speed at the site is higher than 4.5 m/sec. The installation of hydrogen fuel cells in a

Page 5 of 11

John Vourdoubas; Applications of Distributed Electricity Generation Systems in Hospitals. European Journal of

Applied Sciences, Volume 9 No 1, February 2021; pp:10-20

URL: http://dx.doi.org/10.14738/aivp.91.9106 14

military hospital located in Johannesburg, South Africa has been announced [28]. For the

implementation of this project cooperation of the public sector the private sector and the Academia

according to the triple helix model is followed. IEA [29] has reported on the use of solar-PVs in health

care facilities in developing countries. The report mentioned that for the medium and large health

care facilities in rural areas the most economic and reliable power option is hybrid systems consisted

of solar-PVs with diesel generators. Taseli et al [30] have studied the use of biogas for generating heat,

cooling and electricity in a 900-bed university hospital located in Turkey. The authors stated that

biogas could be produced either by anaerobic digestion of organic wastes produced in the free land

surrounding the hospital or by anaerobic digestion of the livestock wastes of an organic farm created

by the hospital in the nearby area. Pina et al [31] have studied the opportunities of integrating solar

thermal, solar-PV and biomass technologies for energy generation in a Brazilian hospital. The authors

mentioned that biomass was economically the most appropriate fuel for heat production. They also

stated that solar-PVs could be used in the hospital for offsetting the annual grid electricity

consumption while solar thermal technology had various drawbacks compared with biomass and

natural gas. Donuk et al [32] have reported on an application of a parabolic trough collector system

to a hospital building located in Aydin, Turkey. The authors mentioned that the power of the tri- generation system was 1 MW while it was going to generate electricity, heat and cooling used in the

hospital. They also mentioned that solar energy was going to heat an oil at 225o

C which was used in a

Organic Rankin cycle system for electricity generation. The remaining low enthalpy heat was used for

heating in the winter and for cooling in the summer. Good et al [33] have reviewed various projects

related with the use of hybrid photovoltaic-thermal systems in buildings. The authors mentioned that

the PV/thermal market is still small while these systems are not cheaper than alternative installations.

Chow et al [34] have reviewed the integration of solar thermal and solar-PV systems. The authors

mentioned that the limited available space in buildings for solar energy systems installation and the

promotion of low carbon/zero energy buildings have increased the demand for hybrid solar energy

systems. They also mentioned that innovative hybrid solar energy systems have been developed and

commercialized but real system applications are limited so far.

Aim of the current work is the review of various distributed generation systems which could be used in

hospitals.

Initially the existing literature is surveyed followed by an estimation of energy consumption in

hospitals. After that the main distributed generation systems are presented and the possibility of using

them in hospitals is investigated. The findings of the work are discussed followed by the presentation

of the conclusions drawn and some proposals for further work.

3 Energy consumption in hospitals

Hospitals utilize energy for heating, cooling, hot water production, lighting and the operation of

various electric devices, medical equipments and machinery including those in the kitchen, laundry

and surgery rooms. Hospitals are among the most energy consuming buildings having higher energy

consumption than hotels, offices, commercial buildings, schools and residential buildings. Published

research, presented in table 1, indicates that the annual specific energy consumption in hospitals

worldwide varies between 254.9 KWh/m2 and 738.5 KWh/m2

.

Page 6 of 11

European Journal of Applied Sciences, Volume 9 No. 1, February 2021

Services for Science and Education, United Kingdom 15

Table 1. Energy consumption in hospitals

Author Year Country Annual energy

consumption (KWh/m2)

Gonzalez, Gonzalez et al 2018 Germany 270

Hu et al 2004 Taiwan 259.45

Garcia-Sanz-Calcedo et al 2018 Spain 270

Biglia et al 2015 Italy 254.9

Bawaneh et al 2019 USA 738.5

Jiang et al 2012 China 348

Santamouris et al 1994 Greece 407

Vourdoubas 2018 Greece 280.4

Source: Published literature

According to many researchers (Biglia et al [4], Jiang et al [6], Vourdoubas, [7]) the main energy

source used in hospitals is electricity having a share at 57 % to 72.11 % in the total energy mix while

the share of fuel oil varies between 27.89 % and 43 %. Use of various renewable energy technologies

in European hospitals has not been prioritized so far [22].

4 Distributed electricity generation systems

Various distributed electricity generation systems are currently used for electricity generation, co- generation of heat and power or tri-generation of electricity, heat and cooling. These include:

4.1 Solar photovoltaic systems

Solar-PV systems are currently used for electricity generation. Depending on the intensity of the solar

irradiance these systems are more or less attractive while they could generate part or all of the annual

electricity requirements of the grid connected consumer. They are intermittent energy generation

systems while their cost has been substantially reduced during the last 15 years. Their average energy

efficiency varies between 14-18%. In areas with high solar irradiance solar-PV systems are cost

competitive with conventional electricity generation systems using fossil fuels.

4.2 Heat and power co-generation systems, tri-generation systems

Co-generation systems generate both heat and electricity from the same machine. Their energy

efficiency is high at approximately 80-90% while the most often used fuel is natural gas. They are cost- effective and they are currently used in industry, in buildings and in agriculture achieving continuous

energy generation. Due to their high energy efficiency their carbon emissions into the atmosphere are

low compared with other electricity generation technologies. Tri-generation systems use the same

technology with co-generation systems but during the summer the co-generated heat is utilized by

thermal chillers for cooling production resulting in electricity, heat and cooling production.

4.3 Fuel cells

Fuel cells are modern energy production systems utilizing H2 or some compounds containing H2, like

CH3OH or CH4, for electricity generation with electrochemical processes. They can co-generate heat

achieving power efficiencies at 40-50% and heat efficiencies at 30-40%. Therefore their overall energy

efficiency is high. Their commercial applications are rather limited due to their high initial cost while

in some countries their installation is subsidized by the government. The main fuel used is natural gas

resulting in low carbon emissions into the atmosphere. Hydrogen can be also utilized in fuel cells while

in the case that the H2 is produced from renewable energies the carbon emissions due to energy

generation are zero.

Page 7 of 11

John Vourdoubas; Applications of Distributed Electricity Generation Systems in Hospitals. European Journal of

Applied Sciences, Volume 9 No 1, February 2021; pp:10-20

URL: http://dx.doi.org/10.14738/aivp.91.9106 16

4.4 Wind turbines, biogas, small hydroelectric systems, hybrid PV-solar

thermal and solar thermal power systems

Additionally various other renewable energy technologies could be used for electricity generation in

large buildings whenever it is technically and economically feasible. These include:

4.4.1 Wind turbines

Small size wind turbines can be integrated in buildings for electricity generation. Necessary pre- condition for that is the high annual average wind speed at the site of the building. Wind turbines

require more maintenance than solar-PVs and their applications in residential or commercial buildings

are still limited.

4.4.2 Biogas

Biogas can be used for electricity generation in hospitals while the co-produced heat can be also used

for covering part of their heating needs. Biogas production by anaerobic digestion of organic wastes

is currently technically and economically feasible and this fuel is used for energy generation or co- generation of heat and power.

4.4.3 Small hydroelectric systems

In some cases small hydroelectric systems could be used for electricity generation. This is a preferable

solution in developing countries when the health care center is located in remote areas without

electric grid infrastructure. A solar-PV system or a small hydroelectric system combined with an

electric battery and a diesel generator could be a feasible solution providing electricity in organizations

located in areas without electric grid infrastructure.

4.4.4 Hybrid PV-solar thermal

Hybrid solar-PV and solar thermal energy systems generating both electricity and hot water could be

integrated in various buildings. Various products are available in the market although the reliability

and the cost-effectiveness of this technology has not been well proven yet and the existing

installations are limited so far.

4.4.5 Solar thermal power systems

Solar thermal power systems with parabolic or disc solar collectors equipped with sterling engines

could be used for co-generation of heat and power. During the last years various products are available

in the market but their reliability and cost-effectiveness has not been proven yet.

Various characteristics of the abovementioned distributed electricity generation systems are

presented in table 2.

Table 2. Characteristics of distributed electricity generation systems

Technology used Total energy efficiency CO2 emissions

Photovoltaic panels 14-18% zero

Parabolic trough or disc solar collectors and steam to power engines 40-50% zero

Hybrid PV – solar thermal 40-50% zero

Wind turbines Low depending on the

average annual wind speed

zero

Hydroelectric turbines 70-80% zero

Biogas burning and steam to power engines 70-80% zero

Electrochemical generation-fuel cells 70-80% Low or zero (if H2

is used)

Gas engines or other technologies - co-generation 80-90% Low

Gas engines and absorption chillers – tri-generation 70-90% Low

Source: Own estimations

Page 8 of 11

European Journal of Applied Sciences, Volume 9 No. 1, February 2021

Services for Science and Education, United Kingdom 17

5 Use of distributed electricity generation systems in hospitals

Various distributed generation systems based either in renewable energies or in very efficient energy

technologies could be used in hospitals reducing their conventional energy and fuel consumption and

their carbon footprint. Their use is desirable since they increase their energy security and self- sufficiency while they result in many benefits in the electric grid. Taking into account that hospitals

require large amounts of heat energy for space heating and hot water production the use of co- generation systems could cover a significant part of their heat and electricity requirements. For

financing the required energy investments hospitals could utilize new financial tools including third

party financing and public private partnerships. An energy saving company (ESCO) could design,

finance and implement the energy investments resulting in benefits both to the hospital and to the

ESCO. The distributed generation systems which could be used in hospitals depend on the availability

of the energy source and the fuel, the maturity and the cost of the energy technologies and the

possibility of achieving support by public subsidies. The sustainable energy systems which could be

used in hospitals include:

a) Renewable energy systems like solar-PV, solar thermal power systems, small wind turbine

systems and systems based in biogas, and

b) High efficiency energy systems like heat and power co-generation systems, heat, cooling and

power tri-generation systems and fuel cells using conventional fuels like natural gas. Their

overall efficiency in heat and power generation is in the range of 80-90 %. The co-generated

heat and cooling could be also used in the hospital.

The distributed electricity generation systems which could be used in hospitals are presented in table

3.

Table 3. Distributed electricity generation systems which could be used in hospitals

Energy source Technology used Intermittent or

continuous

energy

generation

Generated energy

Solar energy Photovoltaic panels Intermittent Electricity

Solar energy Parabolic trough or disc

solar collectors and steam to

power engines

Intermittent Electricity and heat

Solar energy Hybrid PV- solar thermal Intermittent Electricity and heat

Wind energy Wind turbines Intermittent Electricity

Hydro energy Hydroelectric turbines continuous Electricity

Biogas biogas burning and steam to

power engines

continuous Electricity and heat

Natural gas, Hydrogen Electrochemical generation continuous Electricity and heat

Natural gas Gas engines or other

technologies

continuous Electricity and heat

Natural gas Gas engines and absorption

chillers

continuous Electricity, heat and

cooling

Source: Own estimations

6 Discussion

Our results indicate that various distributed generation technologies could be used for electricity

generation in hospitals while some of them co-generate also heat which could be used in them.

Various renewable energy sources are included among the fuels used in these systems. Some systems

are mature, reliable, cost-effective and they are already used in various hospitals. Our results indicate

that the use of these systems could increase the environmental sustainability in hospitals substituting

Page 9 of 11

John Vourdoubas; Applications of Distributed Electricity Generation Systems in Hospitals. European Journal of

Applied Sciences, Volume 9 No 1, February 2021; pp:10-20

URL: http://dx.doi.org/10.14738/aivp.91.9106 18

the use of polluting fossil fuels with green fuels and energy efficient technologies. However the current

work does not indicate which distributed electricity generation systems are cost-effective and

profitable in order to be used in health care buildings. Support of the installation cost of these energy

technologies, which currently are not cost-effective, with public subsidies is required for their

promotion in hospitals.

7 Conclusions

The application of distributed electricity generation in hospitals has been investigated. Various

distributed energy generation systems are already used in industry, agriculture and in large buildings.

Health care buildings require large amounts of energy for covering their annual electricity and heat

requirements while they usually consume grid electricity and fossil fuels having a high carbon

footprint. Their annual energy consumption varies between 254.9 KWh/m2 and 738.5 KWh/m2

.

Various distributed electricity generation systems could be used in hospitals reducing their fossil fuels

consumption as well as their impact to climate change. Some of them, including the use of biogas and

small hydro power, could be used only if the energy source and the fuel are available on-site. The

majority of these systems utilize either renewable energies or natural gas while some of them co- generate heat and power. Their use should be promoted in the future due to the resulted economic

and environmental benefits. Further research should be focused in the investigation of renewable

energy systems which could be used for heat generation in hospitals, like solar thermal energy and

solid biomass burning systems, as well as in the investigation of using very efficient heat pumps for

their air-conditioning. Additionally, research should be focused in the profitability assessment of the

application of these novel energy technologies in hospitals implementing various case studies.

REFERENCES

[1] Gonzalez Gonzalez, A., Garcia-Sanz-Calcedo, J. & Salgado Rodriguez, D., Evaluation of energy

consumption in German hospitals: Benchmarking in the public sector, Energies, 2018. 11: 2279.

doi:10.3390/en11092279

[2] Hu, S.C., Chen, J.D. & Chuah, Y.K., Energy cost and consumption in a large acute hospital, International

Journal of Architectural Science, 2004. 5(1): p. 11-19.

[3] Garcia-Sanz-Calcedo, J., Gonzalez, A.G. & Salgado, D.R., Assessment of energy consumption in Spanish

hospitals, Chapter 56, in the book “The Role of Exergy in Energy and the Environment”, Green Energy and

Technology, 2018. DOI: 10.1007/978-3-319-89845-2_56

[4] Biglia, A., Caredda, F.V., Fobrizio, E., Filippi, M. & Mandas, N. (2015). Modeling of the energy system of

the AOB hospital with the energy hub approach, in ASME-ATI-UIT 2015 Conference on Thermal Energy

Systems: Production, Storage, Utilization and the Environment, 17-20 May 2015, Napoli, Italy.

[5] Bawaneh, K., Nezami, G.F., Rasheduzzaman, Md. & Deken, B., Energy consumption analysis and

characterization of healthcare facilities in the United States, Energies, 2019. 12: 3775.

doi:10.3390/en12193775

[6] Jiang, Ch., Xing, J., Ling, J. & Qin, X., Energy consumption and carbon emissions of hospitals in Tianjin,

Front. Energy, 2012. 6(4): p. 427-435. DOI 10.1007/s11708-012-0199-5

[7] Vourdoubas, J. Energy consumption and carbon emissions in Venizelio hospital in Crete, Greece: can it be

carbon neutral?, Journal of Engineering and Architecture, 2018. 6(1): p. 19-27. DOI: 10.15640/jea.v6n1a2

Page 10 of 11

European Journal of Applied Sciences, Volume 9 No. 1, February 2021

Services for Science and Education, United Kingdom 19

[8] Santamouris, M., Dascalaki, E., Balaras, C., Argiriou, A. & Gaglia, A., Energy performance and energy

conservation in health care buildings in Hellas, Energy Conservation Management, 1994. 35(4): p. 293-

305.

[9] Huang, X., Zhang, Z. & Jiang, J. (2006). Fuel cell technology for distributed generation: An overview, in IEEE

ISIE, pp. 1613-1618, July, 9-12, 2006, Quebec, Canada. DOI: 10.1109/ISIE.2006.295713 · Source: IEEE

Xplore

[10] Yekini Subern, M., Bashir, N., Adefemi, O.M. & Usman, U., Renewable energy distributed electricity

generation, ARPN Journal of Engineering and Applied Sciences, 2013. 8(2): p. 149-156.

[11] Hidayatullah, N.A., Stojcevski, B. & Kalam, A., Analysis of distributed generation systems, smart grid

technologies and future motivators in the electricity sectors, Smart Grid and Renewable Energy, 2011. 2:

p. 216-229. doi:10.4236/sgre.2011.23025

[12] Hansen, Ch. J. & Bower, J. (2004). An economic evaluation of small-scale distributed generation

technologies, Oxford Institute for energy studies. DOI:10.26889/1901795306

[13] Vourdoubas, J., Review of sustainable energy technologies used in buildings in the Mediterranean basin,

Journal of Buildings and Sustainability, 2018. 1(2), 1-11.

[14] Distributed generation of electricity and its environmental impacts, Energy and Environment, U.S.

Environmental Protection Agency, Retrieved at 31/8/2020 from

https://www.epa.gov/energy/distributed-generation-electricity-and-its-environmental-impacts

[15] Purchala, K., Belmans, R., Leuven, K.U., Exarchakos, L. & Hawkes, A.D. (2006). Distributed generation

and the grid integration issues. Retrieved at 31/8/2020 from

https://www.semanticscholar.org/paper/Distributed-generation-and-the-grid-integration-Purchala- Belmans/0ac853ff68991bf5dd91a5c17c02eac8eeaf2746

[16] Paliwal, P., Patidar, N.P. & Nema, R.K., Planning of grid integrated distributed generators: A review of

technology, objectives and techniques, Renewable and Sustainable Energy Reviews, 2014. 40: p. 557-

570. http://dx.doi.org/10.1016/j.rser.2014.07.200

[17] Moroni, S., Antoniucci, V. & Bisello, A., Local energy communities and distributed generation: Contrasting

perspectives and inevitable policy trade-offs beyond the apparent global consensus, Sustainability, 2019.

11, 3493. doi:10.3390/su11123493

[18] Ali, A., Li, W., Hussain, R., He, X., Williams, B.W. & Hammed M.A., Overview of current micro-grid policies,

incentives and barriers in the European Union, United States and China, Sustainability, 2017. 9: 1146.

doi:10.3390/su9071146

[19] Tahboub, R., Ibrik, I. & Tamimi, M. (2011). The potential and feasibility of solar and wind energy

applications in Al-Ahli hospital, In the 4th International Energy Conference in Palestine, January 2011.

[20] Franco, A., Shaker, M., Kalubi, D. & Hostettler, S., A review of sustainable energy access and technologies

for healthcare facilities in the global South, Sustainable Energy Technologies and Assessments, 2017. 22:

p. 92-105. http://dx.doi.org/10.1016/j.seta.2017.02.022

[21] Gupta, S.K., Sharma, J., Varma, V. & Anand, B.S., Designing and application of a renewable energy model

for a tertiary care research hospital, International Journal of Research Foundation of Hospital & Health

Care Administration, 2014. 2(1): p. 57-61.

Page 11 of 11

John Vourdoubas; Applications of Distributed Electricity Generation Systems in Hospitals. European Journal of

Applied Sciences, Volume 9 No 1, February 2021; pp:10-20

URL: http://dx.doi.org/10.14738/aivp.91.9106 20

[22] Towards Zero Carbon Hospitals with Renewable Energy Systems, RES Hospitals (2013), Intelligent Energy

Europe. Retrieved at 28/8/2020 from https://ec.europa.eu/energy/intelligent/projects/en/projects/res- hospitals

[23] Kantola, M. & Saari, A., Renewable vs. traditional energy management solutions – A Finish hospital facility

case, Renewable Energy, 2013. 57: p. 539-545. https://doi.org/10.1016/j.renene.2013.02.023

[24] Mat Isa, N., Shekhar Das, H., Wei Tan, C., Yatim, A.H.M. & Yiew Lau, K., A techno-economic assessment of

a combined heat and power photovoltaic/fuel cell/battery energy system in Malaysia hospitals, Energy,

2016. 112: p. 75-90. http://dx.doi.org/10.1016/j.energy.2016.06.056

[25] Buonomano, A., Calise, F., Ferruzzi, G. & Vanoli, L., A novel renewable poly-generation system for hospital

building: Design, simulation and thermo-economic optimization, Applied Thermal Engineering, 2014. 67:

p. 43-60. http://dx.doi.org/10.1016/j.applthermaleng.2014.03.008

[26] Teke, A., Zor, K. & Timur, O. (2015). A simple methodology for capacity sizing of co-generation and tri- generation plants in hospitals: A case study for a University hospital, Journal of Renewable and

Sustainable Energy, 7, 053102.

[27] Renewable energy for rural health clinics (1998). National Renewable Energy Laboratory, USA. Retrieved

at 31/8/2020 from https://www.nrel.gov/docs/legosti/fy98/25233.pdf

[28] South Africa deploys hydrogen fuel cells in Pretoria hospital to support Coved-19 response, in Fuel Cell

Bulletin, May 2020. Retrieved at 31/8/2020 from

https://www.sciencedirect.com/science/article/pii/S1464285920301772?dgcid=rss_sd_all

[29] PV systems for rural health facilities in developing areas (2014). International Energy Agency, Report IEA- PVPS T9-15. Retrieved at 31/8/2020 from https://iea-pvps.org/wp-content/uploads/2020/01/IEA- PVPS_T9-15_2014_PV_for_rural_health_facilities.pdf

[30] Taseli, B.K., Kilkis, B., Ecological sanitation, organic animal farming and co-generation: Closing the loop

in achieving sustainable development - A concept study with on-site fueled tri-generation retrofit in a 900-

bed University hospital, Energy and Buildings, 2016. 129:p. 102-119.

http://dx.doi.org/10.1016/j.enbuild.2016.07.030

[31] Pina, E.A., Lozano, M.A. & Serra, L.M., Opportunities for the integration of solar thermal heat,

photovoltaics and biomass in a Brazilian hospital, EuroSun 2018, 12th International Conference on Solar

Energy for Buildings and Industry, Rapperswil, Switzerland. DOI:10.18086/eurosun2018.05.03

[32] Donuk, A., Saglam, S., Diner, C., Cerci, Y., Cengel, Y., Gundurn, O., Orioli, F., Somuncu, Y. & Menguc, M.P.

(2016). An application of parabolic trough collector (PTC) system to a hospital building. Retrieved at

8/9/2020 from

https://www.academia.edu/30414608/An_Application_of_Parabolic_Trough_Collector_PTC_System_t

o_a_Hospital_Building

[33] Good, C., Chen, J., Dai, Y. & Hestnes, A.G., Hybrid photovoltaic-thermal systems in buildings – a review.

Energy Procedia, 2015., 70: p. 683-690. doi: 10.1016/j.egypro.2015.02.176

[34] Chow ,T.T., Tiwari, G.N. & Menezo, C., Hybrid solar: A review on photovoltaic and thermal power

integration. International Journal of Photoenergy, 2012. ID 307287. doi:10.1155/2012/307287