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Patients will use infection data to choose hospital

As many as 12 states may have laws by year end

A consumer survey indicates perspective patients are ready to be empowered with medical information and will use infection rate data in selecting a hospital system, an epidemiologist reports.

"You can't pick up a newspaper or turn on a radio without reading or hearing something about infections in hospitals," says Maryanne McGuckin, Dr. ScEd. MT (ASCP), epidemiologist at the University of Pennsylvania School of Medicine in Philadelphia. "People are getting educated and they [are willing] to go where they know there is good care. It's going to be on the hospitals now to say, "'The public wants this; we have this data and we have to present it in a way that is usable and education-friendly.'"

When asked specifically about infection rates, 93% of consumers said knowing infection rates for a hospital or doctor would influence their selection, the study found. Nine in 10 respondents said higher-than-average infection rates would be a very important reason to avoid a hospital or doctor, McGuckin reports.

In press for publication, the study is based on a telephone survey as conducted from Oct. 14-18, 2005. The survey was based on a random digital-dialing probability sample of all households in the United States with a sampling error of plus or minus three percentage point at the 95% level of confidence. Respondents were ages 18 and older. The survey netted 1,008 respondents for a response rate of 12%.

"There were five questions and the first one asked if you had to choose a hospital right now, how would you rank these factors," McGuckin tells Hospital Infection Control. The vast majority (94%) of respondents rate clean as very important, but secondly, 85% listed low infection rates very important in hospital selection, the survey found.

"I think that surprised me the most is how much the public looks at environmental cleanliness," she says. "I think that is striking because there is really no direct correlation between that in infections in the literature. But people look at that."

Another question asked respondents to cite factors that would be important in a decision to avoid a hospital or change to another facility. Respondents listed higher-than-average infection rates as very important in their decision (87%) along with clean (79%) and understaffed (74%), McGuckin found.

Dozen state laws by year's end?

Increasing patient awareness and willingness to take action based on infection rate data corresponds with the sweeping legislative action taking place at the state level. At least 12 states are expected to have hospital infection reporting laws in place by the end of the 2006 legislative sessions, projects the advocacy group that has been pushing the laws, Consumers Union, publishers of Consumers Report. Currently, infection reporting requirements have been adopted in eight, with another four states poised to adopt infection reporting bills soon. Prior to this year, hospital infection reporting requirements were adopted by six states: Illinois, Pennsylvania, Florida, Missouri, Virginia, and New York. The Maryland General Assembly passed reporting bills in April of this year and a Vermont health agency is implementing a state committee's recommendations for hospital infection reporting and is expected to issue its first report in June. According to the Consumers Union, a number of other states are moving closer to hospital infection reporting laws:

Colorado: On May 5, the Colorado legislature approved HOB 1045, which requires hospitals to report incidents of hospital acquired infections to the Centers for Disease Control and Prevention to be analyzed and risk adjusted. The Colorado Department of Public Health and Environment will use that information to provide facility-specific infection rates to the public. Gov. Bill Owens has 30 days to sign the bill into law.
Connecticut: Lawmakers in the state approved SB 160, a bill that requires hospitals to report infections to the Connecticut Department of Health. The department then will make hospital-specific infection rates available to the public. The measure must be approved by Gov. M. Jodi Rill to become law.
New Hampshire: On May 3, the New Hampshire Senate passed HOB 1741, a hospital infection reporting bill previously approved by the House. The bill, which will lead to reports on hospital infection rates, now moves to Gov. John Lynch's desk for consideration.
South Carolina: On April 27, the South Carolina Senate passed S. 1318, which requires hospitals in the state to disclose the rate at which their patients develop surgical site infections, ventilator assisted pneumonia, central line bloodstream infections, and urinary tract infections. The measure is picking up support in the House and stands a good chance of winning passage before the legislature adjourns on June 1.
Alaska: On May 4, the Alaska Legislature adopted a resolution to create a task force to develop recommendations for hospitals to disclose their infection rates, to be presented in the form of legislation in 2007.
Tennessee, Ohio, Rhode Island, and Massachusetts still are also considering hospital infection reporting legislation.