What Are Patients’ Fears Around Hospitalization? A Survey Found Out

What concerns do Americans have about hospitalization? A recent survey’s focus was to understand the perspectives, feelings, concerns, and level of knowledge of risks associated with hospitalization in the United States from both medical and nonmedical individuals.

Greg Bullington, CEO and cofounder, and Christine Chen, vice president of marketing, Magnolia Medical Technologies, Inc., discussed with Infection Control Today^® (ICT^®) the survey’s results. The report, “State of Hospitalized Patient Care in the U.S. 2023,” examines how much individuals understand and worry about these hospital risks, including antibiotic stewardship and hospital-acquired infections.

“We wanted to start broadly to understand just what the level of knowledge and understanding of various types of risks within the hospital environment look like, really, as a baseline, it's our intent to continue this research,” Bullington told ICT. We think there are many important gaps in knowledge and education as it relates to risks associated with a host of factors…. We wanted to calibrate and understand the level of knowledge, concern, and fear amongst the general population and those [who] serve in medically related occupations, including physicians.”

Overall, the main concern of the survey’s participants is the financial implications of hospitalization. “We've all heard stories of how significant the burden can become for folks [who] end up with prolonged hospital stays. So, that was not necessarily a surprise. But as it related to the risk of hospital-acquired infections and antibiotic use, there [were] interesting data and [many] interesting responses. About 75% of the respondents, 3 out of 4, stated they were concerned and believed that health care providers must be more cautious when prescribing antibiotics. The concerns around antibiotic resistance release seem to be generally well understood. But not surprisingly, the bifurcation between the general population and then those employed and medically related occupations, there was a much higher acuity and understanding within the medical profession group than the general population.”

Chen said she was surprised by the number of individuals affected by sepsis. “Either they had been diagnosed with sepsis, or a family or loved one had been diagnosed and cared for sepsis. The other interesting finding from the survey was that individuals who had been directly impacted by sepsis were much more aware of consumer rights when it came to issues associated with antimicrobial resistance and antibiotic-resistant bacteria. And there needed to be more caution and focus on the unnecessary prescribing of antibiotics. The other piece that I thought was super interesting about this patient population was that not only were they more of an aware consumer, but they had the highest level of awareness [regarding] when it came to the impact of inaccurate results. So, these respondents are 45% more aware that inaccurate blood culture results can lead to the unnecessary administration of antibiotics compared to those individuals [who] had not had a diagnosis.”

For infection preventionists, the survey points to areas where they can assist with resisting the antibiotic prescription. “Infection preventionists (IP) play an important role in the institution in terms of the prioritization of various techniques and technologies that are evidence-based to minimize the risk of blood culture contamination, which can lead to the misdiagnosis of sepsis. So there is a vital role that the IP community plays within acute care hospitals to help reduce the incidences of false positive results, which significantly reduces the overuse of these powerful, potent antibiotics, which has the cascading effect and impact of helping stave off a lot of the continued pressure that we have from an antibiotic resistance standpoint.”

Key findings of the survey include:

The financial cost of hospitalization is the most concerning risk for Americans, given the current state of the economy. A survey showed that 55% of respondents are either 'Very' or 'Extremely' fearful about this issue. Additionally, 75% of Americans believe health care providers should be more cautious when prescribing antibiotics. However, there is a significant knowledge gap regarding the risks associated with antimicrobial-resistant bacteria among previously and future hospitalized patients. Therefore, there is a need for more government leadership between health care providers and patients to address this issue.

Regarding infections caused by antimicrobial-resistant bacteria, 52% of respondents are 'Very concerned' or 'Extremely concerned' about the effects on their current or future health. They also agree that more education is needed for patients about this issue. Sepsis is the number one cause of death, readmissions, and costs for US hospitals and is the most feared infection. Nearly half of the survey respondents are either 'Extremely' or 'Very' fearful of sepsis. Additionally, approximately 1/3 of respondents either have had a loved one or have been personally diagnosed with sepsis, making them more knowledgeable about other health care-associated infections.

However, the survey also revealed that approximately 40% of respondents in non-medical related occupations are 'Barely' or 'Not at all' informed about the risk for hospital-acquired infections (HAIs). Nevertheless, 81% of all respondents agree that it is 'Very' or 'Extremely' important to be informed about HAI risk and infection control measures in the hospital if they were to be admitted as a patient.

Finally, 46% of respondents rated the government's performance as either 'Extremely poorly' or 'Poor' when it comes to protecting the health of Americans by addressing preventable medical errors and holding hospitals accountable for key quality measures.