Renewable Investment Research Articles

Fossil fuel curse and green transition: The role of renewable energy and green R&D

Many researchers have documented the effects of deploying natural resources on gross domestic product (GDP) growth and confirmed the existence of the resource curse phenomenon. Furthermore, several studies have proved that factors such as institutional quality, trade openness, and commodity price volatility can alter the effects of natural resource deployment on economic growth. However, few studies have considered the effect of green transition on the resource curse. While transitioning to a green economy poses the threat of reducing the potential revenues from exporting natural resources in resource-abundant economies, it can contribute to economic growth by reducing fossil fuel dependance, increasing energy efficiency, and increasing green competitiveness. In this study, we analyze how fossil fuel rents affect GDP growth and study the interactive effects of renewable energy and investment in green research and development. By using the data of 109 countries for the period 1990–2020, we conduct a panel analysis. The results confirm the existence of the resource curse effect, whereby fossil fuel rents hinder economic growth. In addition, increasing renewable energy deployment can alleviate the adverse effects of fossil fuel rents. This mitigation can occur through a reduction in the domestic consumption of fossil fuels, increased access to international trade, and infrastructure investments. Lastly, increasing investments in green research and development mitigates the adverse effects of fossil fuel deployment. This result is achieved because of increases in energy efficiency, investment in human capital, and green competitiveness. We conclude that active green transitioning, especially in fossil-fuel-rich economies, can lead countries to sustainable growth.

Climate change and food security nexus in Ghana: The role of renewable energy.

Climate change is aggravating hunger, which is miserable in Sub-Saharan African nations like Ghana. Yet evidence of the effect of climatic variables on hunger, particularly multidimensional food security, is less illuminated in Ghana. Moreover, the decoupling effect of renewable energy on emissions and food security is rare in the Ghanaian context. Therefore, we fill this gap using time series data from 1990 to 2022. The autoregressive distributed lag model was used to analyse the data, while the dynamic ordinary least squares and fully modified ordinary least squares were employed for robustness. Additionally, the seemingly unrelated regression was used to evaluate the effect of climate change on tomatoes, rice, cocoa, cashews, maize, cassava, and yam output. We discovered a long-run co-integration between climatic factors and food security. Moreover, rising temperatures worsen food security in the short run but eventually improve in the long run. Again, temperature improves the production of the studied crops. In the short term, precipitation disturbs food security but suddenly improves in the future. Similarly, rainfall increases the production of the studied crops. Moreover, CO2 stifles long-term food security and reduces rice production. However, renewable energy counteract the deleterious consequence of CO2 on food security in the future. Theoretically, the effect of climate change on food security follows the assumption of the Environmental Kuznets Curve to some extent in Ghana. Therefore, adopting irrigation, greenhouses, agricultural insurance, and improved crop varieties will help farmers manage the wrath of climate change. Also, policies like carbon credits, tax incentives for renewable energy, investment funds, and solar panel subsidies can further promote sustainability and climate change mitigation.

The Philippines’ Energy Transition: Assessing Emerging Technology Options Using OSeMOSYS (Open-Source Energy Modelling System)

The Philippines aspires for a clean energy future but has become increasingly reliant on imported fossil fuels due to rising energy demands. Despite renewable energy targets and a coal moratorium, emissions reductions have yet to materialize. This study evaluates the potential of offshore wind (floating and fixed), floating solar PV, in-stream tidal, and nuclear power to contribute to a Net-Zero energy plan for the Philippines, utilizing the Open-Source Energy Modelling System (OSeMOSYS). Seven scenarios were analyzed, including least-cost, renewable energy targets; Net-Zero emissions; and variations in offshore wind growth and nuclear power integration. Floating solar PV and offshore wind emerged as key decarbonization technologies, with uptake in all scenarios. Achieving Net-Zero CO2 emissions by 2050 proved technically feasible but requires substantial capital, particularly after 2037. Current renewable energy targets are inadequate to induce emissions reductions; and a higher target of ~42% by 2035 was found to be more cost-effective. The addition of nuclear power showed limited cost and emissions benefits. Emissions reductions were projected to mainly occur after 2038, highlighting the need for more immediate policy action. Recommendations include setting a higher renewables target, offshore wind capacity goals, a roadmap for floating solar PV, and better incentives for private investment in renewables and electric transport.

Free autonomy renewable trade markets for government independence and carbon neutrality transitions with grid-demand-storage synergies

<p>Along with the gradual phase-out of fossil-fuels, technology readiness and cost decline of renewable energy technologies and battery storages can bring new prospects for renewable energy trading market and extensive power-sector decarbonization. Renewable energy trading market has rapidly transformed from traditional grid-based transactions towards future direct free trading with multi-stakeholders. However, the direct free trading market for sustainable development of renewable energy systems is unclear, in terms of establishment conditions, increased profit margin and promotion initiatives. In this study, free trading markets with spontaneous renewable system installations among stakeholders instead of government are proposed for spatiotemporal energy and economic balances with different types of buildings and electric vehicles (EVs). For the centralized renewable energy system, it is proposed based on energy transmission and energy trading between centralized PV farms and consumers. Besides, free trading market in the distributed renewable energy system is also established between EV owners and prosumers with flexible energy management strategies (i.e. EV energy sharing, and EV battery cascade utilization). Roles of EVs under vehicle-to-everything (V2X) with different charging/discharging modes are analysed considering the trade-off between additional expenditures on EV battery cycling aging costs and additional economic profits for economic feasibility and carbon emission reduction for environmental sustainability based on dynamic energy trading mechanism and associated cost decline. The results suggest that, due to the rapid decline in the costs of both renewables and batteries, along with the increased penetration of renewable energy in centralized systems, the free-market trading model could become widely accepted by 2060. Due to the rapid decrease of battery cost and increase in grid price, the EV owners will transit from cost payers to economic earners, along with the levelized cost of charging (LCOC) with EV energy sharing decreases from 2.24 CNY/kWh in 2020 to -1.27 CNY/kWh in 2060. Furthermore, retired EV battery cascade utilization in building energy storages can reduce the levelized electricity cost (LEC) of residential building owners. Overall, this study provides valuable insights into dynamic evolutions of free trading markets on renewable energy which significantly encourages spontaneous renewable investments and trading behaviours for the sustainable renewable energy deployment.</p>

Evaluation of the Effect of Green Energy Policy on Renewable Power Plant Investment in Indonesia

Indonesia’s transition to renewable energy is a pivotal aspect of its strategy to achieve sustainability and reduce greenhouse gas emissions. This study evaluates the impact of green energy policies on renewable power plant investments in Indonesia through a comparative analysis of solar, wind, geothermal, and hydropower projects. Using data from 2015 to 2024, the study examines the effectiveness of feed-in tariffs, tax incentives, and renewable energy mandates in driving investments. The results show that while policies like feed-in tariffs and tax incentives have significantly boosted investment in geothermal and hydropower projects, solar and wind energy sectors face challenges such as low tariff rates and infrastructure deficits. Comparative insights from successful international cases underscore the need for policy stability, grid expansion, and technology-specific strategies. This research provides actionable recommendations to optimize Indonesia’s green energy framework, fostering a more inclusive and sustainable renewable energy sector.

Optimization of long-term renewal investment plan for drinking water conveyance networks using dynamic programming

ABSTRACT The increasing issue of aging water pipes highlights the need for a long-term renewal investment plan to respond effectively within constrained resources. This study proposes an optimization method designed to minimize life cycle costs while considering the structural safety of pipes and economic efficiency in pipe renewals. The method consists of two prediction models: artificial neural network (ANN)-based corrosion prediction models and ANN-based failure rate prediction models. This study uses these models to develop a dynamic programming (DP)-based optimization method that meets annual budget constraints. It applies successfully to a target area of conveyance pipe networks. Moreover, the findings demonstrate that adhering to annual budget constraints allows water utilities to allocate their budgets efficiently, facilitating strategic investments within set yearly limits. These findings offer substantial promise as foundational technologies for the asset management of water supply infrastructures, highlighting their potential for future applicability and value.

Driving Renewable Energy Innovation Investments: Is Venture Capital a Novel Strategic Choice? Evidence from China

The relationship between venture capital (VC) and corporate innovation has been a topic of debate. Most existing studies have focused on the general effects of VC on innovation investments, neglecting the specific mechanisms. In the global transition toward low-carbon energy, renewable energy (RE) is increasingly becoming a focus area for VC. However, whether VC can effectively stimulate innovation investments in RE firms remains uncertain. This study addressed these gaps by systematically investigating the impact of VC on renewable energy innovation investments (REII) using data from 114 listed RE companies in China from 2011 to 2023. Our findings demonstrate that VC significantly stimulates REII, with a particularly pronounced effect in high-growth and profitable companies, thereby providing new empirical evidence to the ongoing debate on VC's role in corporate innovation. Furthermore, we uncover that VC not only alleviates financial mismatch but also reduces rent-seeking costs, thereby indirectly fostering innovation. These mechanisms help explain how VC can enhance the innovation capabilities of RE companies. Lastly, we find that joint VC, state-owned VC, and long-term VC are especially conducive to promoting innovation. Based on these findings, we offered targeted policy suggestions to boost the innovation potential of China’s RE sector.

Rediscovering the multinational enterprise: the rise and fall of ‘corporate escape’ studies

Recent scholarship has revealed the rapid post-1980s growth, dramatic scope, and socio-economic consequences of multinational enterprises’ (MNEs) corporate tax avoidance and tax haven use. But why did social scientists only start systematically studying these dynamics in the 2010s? This is especially puzzling for International Political Economy (IPE) given that early IPE, in the 1970s, centered analyses of MNEs and their tax affairs under a rubric that Charles Kindleberger called ‘corporate escape’. Drawing on a collective oral history from pioneer interviews, historical documents, and bibliometric analysis, we identify two factors that explain the 1970s origins, the late-century fall, and the recent rise, of corporate escape studies: engagement with transdisciplinary technical knowledge of MNEs, and interaction with the politicization of MNEs. We explain how researchers abandoned the corporate escape agenda in the 1980s–1990s, losing technical insights from cognate disciplines and institutions, and refocusing around economistic and macro-structural analyses. These factors also elucidate why corporate escape studies only fully reinvigorated in the 2010s with political tailwinds and renewed investments in transdisciplinarity. These insights contribute to debates on IPE history and research, reintroduce MNEs as key meso-level institutions, and underscore the importance of historical awareness for studying corporate (mis)conduct and global inequalities.

Bridging the implementation gap for climate mitigation in ASEAN: a comprehensive capacity-building framework

PurposeThe paper systematically examines the capacity building needs of energy and climate stakeholders in the Association of Southeast Asian Nations (ASEAN). It looks at conditions and opportunities for improvements in institutional, organisational, technological, innovation and financing capacities. This paper provides a guide to concrete capacity building programs and implementations to accelerate the implementation of National Determined Contributions (NDCs) and low-carbon energy transition in the ASEAN region.Design/methodology/approachThis paper proposes a comprehensive capacity-building framework, drawing on transition management theory and the interactive systems framework for capacity building. The assessment is based on interviews with representatives of the ministry responsible for energy policy and the ministry responsible for climate policy in each ASEAN country, as well as a survey among a broader set of Southeast Asian energy and climate experts from academia, think tanks and international development partners.FindingsThe paper identifies the priority areas for capacity building for each ASEAN country and the region as a whole. Each country has a unique set of needs and priorities. At the regional level, the widest capacity gaps were observed in institutional capacity, technical capacity, human resources capacity, financing capacity and the capacity to develop policy and legislation. Specific gaps for capacity building are discussed in delivering strategic areas of energy transition, such as electrification of transportation, development of the green supply chain, deploying renewable energy, energy efficiency, strengthening finance and investment and reducing dependencies on fossil fuels.Originality/valueThis paper helps fill the gap for detailed capacity needs analysis and facilitates long-term plans/strategies and their implementation. The insights help to increase ASEAN energy and climate stakeholders’ understanding of the interaction between energy and climate, therefore enhanced capability in developing more effective action maps and intervention points in achieving NDCs and sustainable development goals.

HIV pre-exposure prophylaxis programmatic preferences among people who inject drugs: findings from a discrete choice experiment

BackgroundPre-exposure prophylaxis (PrEP) holds promise for decreasing new HIV infections among people who inject drugs (PWID), yet daily oral PrEP use is low, and PrEP modality and delivery strategy preferences in this population remain understudied.MethodsFrom May 2022-June 2023, we conducted a discrete choice experiment (DCE) with PWID in San Diego, California. Participants viewed 18 PrEP program scenarios in sets of three and chose their preferred scenario within each set. Scenarios consisted of various combinations of five characteristics: PrEP modality (injectable, implantable, oral), frequency of use (annual, bi-monthly, daily), service location (community-based organization, clinic, telemedicine), prescription access location (on-site, street outreach, mail), and adherence supports (social support, outreach worker, phone/text reminder). Multinomial logit regression estimated probabilities of choosing PrEP program scenarios as a function of the five characteristics to estimate part-worth utility scores (PWUS; reflecting relative preferences for specific characteristic values) and relative importance scores (RIS; reflecting the relative influence of each characteristic on program choice). We also explored differences by hypothesized modifiers of preferences (i.e., sex assigned at birth, housing status, injection frequency, prior PrEP awareness).ResultsAmong 262 participants, mean age was 43.1 years, and most reported male sex assigned at birth (69.5%), identified as non-Hispanic (60.3%), and were previously unaware of PrEP (75.2%). Frequency of use (RIS: 51.5) and PrEP modality (RIS: 35.3) had the greatest influence on PrEP program choice. Within these characteristics, participants had relative preferences for annual use (PWUS: 0.83) and oral PrEP (PWUS: 0.57), and relative aversions to daily use (PWUS: -0.76) and implantable PrEP (PWUS: -0.53). Generally, participants did not indicate preferences for specific service or prescription access locations, or adherence supports; however, among those with prior PrEP awareness, prescription access location and adherence supports had a slightly greater influence on PrEP program choices.ConclusionOur study considered diverse PrEP scenarios and highlighted potential preferences for long-acting oral modalities. Although not currently available, renewed investment in long-acting oral PrEP formulations may facilitate PrEP care engagement among PWID. Additional delivery and implementation strategy research is needed to support PrEP uptake and persistence in this population.

Advances in mRNA LNP-Based Cancer Vaccines: Mechanisms, Formulation Aspects, Challenges, and Future Directions.

After the COVID-19 pandemic, mRNA-based vaccines have emerged as a revolutionary technology in immunization and vaccination. These vaccines have shown remarkable efficacy against the virus and opened up avenues for their possible application in other diseases. This has renewed interest and investment in mRNA vaccine research and development, attracting the scientific community to explore all its other applications beyond infectious diseases. Recently, researchers have focused on the possibility of adapting this vaccination approach to cancer immunotherapy. While there is a huge potential, challenges still remain in the design and optimization of the synthetic mRNA molecules and the lipid nanoparticle delivery system required to ensure the adequate elicitation of the immune response and the successful eradication of tumors. This review points out the basic mechanisms of mRNA-LNP vaccines in cancer immunotherapy and recent approaches in mRNA vaccine design. This review displays the current mRNA modifications and lipid nanoparticle components and how these factors affect vaccine efficacy. Furthermore, this review discusses the future directions and clinical applications of mRNA-LNP vaccines in cancer treatment.

A legal-economic framework of wholesale electricity markets: Assessing Australia's transition

Recent years have seen a surge in renewable generation investment in many countries, displacing traditional fossil-fuel generation at scale. Clean energy transitions have amplified existing problems of wholesale market designs and introduced new ones, including, but not limited to maintaining system resilience and reliability and ensuring adequate future investment levels. We develop an integrated legal-economic framework of wholesale electricity markets under transition conditions. The framework explains the dynamic interplay between different levels of electricity market regulation, regulatory objectives, policy instruments, market outcomes and electricity system objectives. The novelty arises from our separation and definition of the two main levels of (energy) law and regulation shaping electricity market design and their unique impact on market and system outcomes. We show that understanding and targeting the different levels of regulation matters for successfully addressing transition problems. We demonstrate the framework on the example of Australia's National Electricity Market.

Quantifying benefits of renewable investments for German residential Prosumers in times of volatile energy markets

The COVID-19 pandemic and the Russian invasion of Ukraine have led to unseen disruptions in the global energy markets since the end of 2021. Residential renewable investments like photovoltaic systems, battery home storage systems, and heat pumps are therefore gaining traction. However, the benefits of those technologies during the energy crisis and beyond have not been fully quantified yet. Therefore, in this study, we benchmark renewable investments for a broad variety of single-family homes by evaluating potential cost savings and emission reductions. In addition, the study considers the influence of recent political incentives and subsidies. The results show that photovoltaic systems are a no-regret investment decision, both economically and environmentally. At the climax of the energy crisis, a typical German household with a heat pump could save 1850 € and reduce equivalent CO2 emissions by 250 g/kWh annually. Politically introduced price breaks on electricity and natural gas do not reverse this advantage. Furthermore, when owning an electric vehicle renewable investments are often more beneficial.

Current status of immunodeficient mouse models as substitutes to reduce cat and dog use in heartworm preclinical research

Chemoprophylactic prevention of veterinary heartworm disease in companion animals, caused by the vector-borne nematode parasite Dirofilaria immitis, is a multi-billion-dollar global market. Experimental use of cats and dogs in preclinical heartworm drug testing is increasing due to evolving drug-resistance to frontline macrocyclic lactones and renewed investment in alternative preventative drug research. We and others recently published data demonstrating proof-of-concept of utilising lymphopenic severe-combined immunodeficient (SCID) or Recombination Activating Gene (RAG)2 deficient mice with additional knockout of the IL-2/7 receptor gamma chain (γc) as alternative preventative drug screening research models of dirofilariasis. Here we summarise the current knowledge of candidate immunodeficient mouse models tested, including a comparison of susceptibility using different background strains of mice, different D. immitis isolates, following use of anti-inflammatory treatments to further suppress residual innate immunity, and efficacies achieved against different reference anthelmintics. We supplement this precis with new data on treatment response to the veterinary anthelmintic, oxfendazole, and initial evaluation of D. immitis susceptibility in CB.17 SCID and C57BL/6 RAG2-/-γc-/- mice. We conclude that in addition to NSG and NXG mice, RAG2-/-γc-/- mice on either a BALB/c or C57BL/6 background offer an alternative screening model option, widening access to academic and commercial laboratories wishing to pursue initial rapid in vivo drug screening whilst avoiding potentially unnecessary cat or dog testing.

Production of energy from renewable sources and financial performance of European utilities: A panel-data analysis

Energy transition has become a priority for utilities worldwide.Renewable electricity generation represents one of the pillars of the European decarbonization policy and is included among eligible activities in the Taxonomy Regulation.The limited literature regarding the effects of investments in renewables on the financial performance of firms is fundamentally split in two lines: the first is focused on stock returns, the second concerns the determinants of the financial performance which is measured either through risk or accounting metrics. A limited set of studies has assessed the effects of investments in renewable power generation on the performance of utilities. In this article three linear regression analysis conducted on a panel-data composed of firm-year observations for 64 electric utilities from continental Europe between 2011 and 2020 are presented. The analysis has focused on: (i) profitability (Return-On-Asset), (ii) market valuation (Tobin's q) (iii) risk (Weighted Average Cost of Capital).The results show that the renewable generation share is significantly and positively correlated with the first two indicators, while not correlated with the cost of capital.This could represent a constraint to investments in renewable generation capacity with a negative impact on the achievement of the targets of the European decarbonization policy.

How Private Equity funds can spur new investment in the Global SAM and MOGI Sectors under various uncertainties- Part-1

While operationally most of the SAM and MOGI sectors, when developed, are lucrative, they also suffer from an array of uncertainties and disruptions. It becomes less acceptable for long term investors when the uncertainties continue to hog the market; as it is happening now. While globally, the governments are keeping away from the risky investments, the private equity investment can be a method for renewed investments in the SAM and MOGI sector, starting from exploration to the value chain investing while the fields are operational. In order to be rational to the investing as well as to protect investor interest, the governments must play an alert but flexible watchdog role.

Time-varying relatedness and structural changes among green growth, clean energy innovation, and carbon market amid exogenous shocks: A quantile VAR approach

Green growth has become a critical driver in sustainability science. However, attaining a steady state of green growth can be challenging in the face of exogenous economic shocks. As such, this study assesses the time-varying relatedness among the USA's green economy (OMXGE), carbon markets (CCAI), green energy (ECO), natural resource markets (SPNGR), and sustainability index (DJS) considering multiple economic traumatism (i.e., the Brexit, COVID-19, Russia-Ukraine conflict). By deploying the quantile VAR (QVAR) and “Wavelet Local Multiple Correlations (WLMC)” approaches, we find: 1) Without the quantile effect, we note strong total interconnectedness among the designated series, which is close to 93 %. 2) From the QVAR findings, we note a high shock-receiving tendency in ECO and CCAI during the Brexit referendum, the first wave of COVID-19, and the Ukraine-Russia conflict, making these markets attractive for further investment during turbulent times. 3) DJS and OMXGE are temporary shock receivers and predominant shock transmitters, indicating that the green economy and sustainability indicators are not robust enough to absorb shocks during economic shocks. 4) Wavelet coherence findings further validate that the green economy is not a safe haven asset, whereas the carbon market has a strong shock absorption capacity and can provide strong hedging support. The underlying findings reveal that Washington's policy toward a renewable-based equity market should be more liberal to ramp up investment in renewables.

Impact of the Coronavirus Disease 2019 Pandemic on Substance Use Disorder Risk Among People Living With Human Immunodeficiency Virus (HIV) Enrolled in HIV Care in the United States: An Interrupted Time Series Analysis.

Rising overdose deaths globally and increased social isolation during the coronavirus disease 2019 (COVID-19) pandemic may have disproportionately impacted people with human immunodeficiency virus (PWH) with substance use disorders (SUD). We examined trends in SUD risk among PWH before and after the COVID-19 shelter-in-place (SIP) mandate. Data were collected between 2018 and 2022 among PWH enrolled across 8 US sites in the Centers for AIDS Research Network of Integrated Clinical Systems cohort. We evaluated changes in moderate/high SUD risk after SIP using interrupted time series analyses. There were 7126 participants, including 21 741 SUD assessments. The median age was 51 (interquartile range, 39-58) years; 12% identified as Hispanic or Latino/Latina, 46% Black/African American, and 46% White. Moderate/high SUD risk increased continuously after the pandemic's onset, with 43% (95% confidence interval [CI], 40%-46%) endorsing moderate/high SUD risk post-SIP, compared to 24% (95% CI, 22%-26%) pre-SIP (P < .001). There were increases in the use of heroin, methamphetamine, and fentanyl, and decreases in prescription opioids and sedatives post-SIP. Further, there was a decrease in reported substance use treatment post-SIP compared to pre-SIP (P = .025). The rising prevalence of SUD through late 2022 could be related to an increase in isolation and reduced access to substance use and HIV treatment caused by disruptions due to COVID-19. A renewed investment in integrated substance use treatment is vital to address the combined epidemics of substance use and HIV following the COVID-19 pandemic and to support resilience in the face of future disruptions.

An exploratory study on the adaptation strategies of longtail boat tour operators to an evolving marine business landscape: a case study of Phuket Island, Thailand

ABSTRACT In Thailand's marine tourism, longtail boat operators play a vital role in local economic growth, cultural heritage preservation. Recognizing their significance, it is important to support these operators by understanding their adaptation to the fast changing business landscape. This study investigates the situation and adaptation strategies of longtail boat tour operators in Phuket, Thailand. Semi-structured interviews were conducted to gather data and discuss the findings’ implications. Findings indicate a resurgence in tourism and a corresponding increase in revenue, driven by a sense of optimism and renewed investment among boat operators. Amidst this rebound, operators exhibit different service design strategies, with some retaining traditional business practices. However, the emergence of new domestic and foreign competitors in marine tourism has prompted a shift towards community empowerment. Simultaneously, the study underscores the pressing issue of business succession. The reliance of traditional maritime skills and the transfer of the skills across generations is at risk due to the younger generation's employment preferences. Emerging environmental challenges, such as climate change and unseasonal weather, further complicate the situation, along with increased water traffic. This research enhances understanding of how longtail boat tour operators adapt to business challenges, offering insights for stakeholders and policymakers in marine tourism.

Deferred maintenance of physical infrastructure and its association to hospital profitability in Washington State

PurposeThe aim of this study is to understand health-care facilities’ practice of deferring maintenance and to identify the relationship between deferred maintenance and hospital profitability.Design/methodology/approachFinancial statements from hospitals in Washington State were analyzed. Differences in building and equipment values were compared to the capital renewal investment benchmark. Then, linear regression analysis was conducted to identify correlations between deferring or sustaining maintenance and a hospital’s profitability.FindingsThe majority of hospitals in Washington State practice deferred maintenance, investing less in annual facility capital renewal than benchmark amounts. Hospitals in deferred and sustained maintenance states do not significantly differ in terms of facility size and plant operating expenses but there is a statistically significant difference in profit margins. Furthermore, a linear relationship exists between the level of investment in facility renewal and overall hospital expenses, revenue and profit.Practical implicationsThe findings of this research can be used to support fiscal policies related to maintaining aging health-care facility infrastructure. The findings can also be used to overcome barriers to securing capital budgets that are sufficient to optimize the safety and performance of the built environment.Originality/valueHospitals in a state of deferred maintenance return higher profits than do hospitals in a state of sustained maintenance. Nevertheless, hospital spending on deferred maintenance backlog reduction generates a positive return on investment. While hospitals may achieve higher returns, in the short term, by spending less on facility capital renewal and focusing instead on higher-revenue-generating opportunities, additional research in necessary to understand the long-term costs of deferring facility infrastructure repairs and replacement.