This paper aims to review the state of the art technologies for the energy efficiency within the hospitals sector. Hospitals are liable for an unstable amount of energy demand and joint emissions, because of their 24/7 nature of operation and hence resulting larger energy consumption than a typical commercial building. Additionally, they need high quality and warranted supplies of electricity. Due to increased energy demand and therefore the depletion of existing fossil fuel based sources, it is required to use the energy more efficient.

Many recent major studies, including the IPCC’s Fourth Assessment Report, have attested that energy efficiency is humanity’s prime option to combat climate change in the short- to mid-term. The potential to avoid CO2 emissions cost-effectively has been reported to be significant through efficiency policies. However, the review of global research findings on the quantification of cost-effectiveness of opportunities through improved efficiency has highlighted that there is a major shortcoming in the vast majority of such calculations.

Cooperation between public and private sector has achieved a remarkable widespread, in the Italian context, over the last two decades. Nevertheless, the increasing difficulty in accessing the capital market and the rising cost of funding sources, both noticeable over the past few years, led to a slowdown of Public–Private Partnership (PPP) initiatives. Meanwhile, the community is expressing new needs to be satisfied, such as the conversion of brownfields, the recovery of housing stock dating back to former times, as well as the refurbishment of public offices or schools.