Choosing a hospital and physician: Does the public really care about infection rates and being informed?

BACKGROUND: The American Medical Association (AMA) has defined six necessary components of an informed consent document: diagnosis, nature, purpose, risks, benefits of proposed and alternative treatment or procedure, and risks and benefits of no treatment or procedure. It remains unclear whether the general public's knowledge before entering the hospital setting is in fact “informed.”

OBJECTIVES: To evaluate the public's knowledge of “informed consent,” healthcare-acquired infections (HAIs) and factors considered in choosing a hospital.

METHODS: An inner-city university population was surveyed through convenience sampling utilizing yes/no and open-ended responses as well as an online survey representing a random population.

RESULTS: Seventy-one percent of respondents identified all six of the AMA's criteria for informed consent to be information needed before signing the document. Thirty-five percent of respondents ranked a physician's procedure mortality rate to be most important. However, no respondent ranked a physician's infection rate to be the most important information. Variables of post-procedure well-being (pain, recovery time) were most important, and malpractice record and insurance coverage were least important. Eighty-five percent of respondents were aware of HAIs, and 81% knew the importance of hand hygiene. Only 17% of respondents felt there was a need to know infection rates prior to hospitalization. In fact, when choosing a hospital, infection rates ranked 10th in a list of 13 important factors, but were the number one reason consumers said they would leave a hospital system. Eighty-four percent of respondents were willing to pay additional money for infection control programs that were designed to allow them to take a pro active approach to their own care.

CONCLUSIONS: Although there is an understanding of the components of an informed consent document, respondents did not identify infection rates to be important before signing a consent form or entering a hospital although they indicated they would leave a hospital system if the rates were high. These findings strongly suggest there is a critical need for consumer education about infection rates in light of state mandatory reporting program for HAIs.