A systematic review of circular economy literature in healthcare: Transitioning from a 'post-waste' approach to sustainability

The healthcare sector generates significant waste and environmental challenges, making the adoption of circular economy principles increasingly urgent. While research on circular economy adoption in healthcare has grown, a critical gap exists in understanding how the field evolves and the primary themes driving this transformation. This study employs bibliometric and content analysis to systematically review the intellectual structure and current state of circular economy research in healthcare. Analysing academic papers published between 2014 and 2024, this review identifies four key themes: healthcare waste management, sustainable product design, economic and policy frameworks, and education and stakeholder engagement. The findings highlight an imbalance in the research landscape, emphasising operational challenges strongly, while systemic enablers remain largely underexplored. Although Europe leads in adopting CE practices, significant research gaps persist in Asia and North America. Key barriers, including regulatory constraints, resistance to change, and concerns around patient safety, continue to impede the effective implementation of CE, particularly in the reuse and recycling of medical devices. This study proposes research on three key areas: evaluating the impact of the existing economic and policy frameworks; sustainability education, aimed at embedding circular economy principles into healthcare training programs; and operationalising circular supply chains, focusing on reverse logistics for medical device recovery and recycling. This review contributes to Step 1 of circularity by addressing waste minimisation at the source. It also identifies gaps in research and geographic disparities to advance Step 2 of circularity, which is focused on resource recovery and reuse. Finally, it provides actionable recommendations for Step 3, which aims to build systemic resilience and reduce carbon footprints through circular supply chains and sustainable procurement.