Consumers cite infection rates and cleanliness as two of the three most important factors when choosing a hospital, outranking other factors such as reputation and proximity, according to a survey released Tuesday by researchers at the University of Pennsylvania.

According to the survey, when information about hospital acquired infection (HAI) rates is made available, patients are likely to choose institutions with the lowest rates. More than 30 states have either considered or are now considering legislation requiring public reporting of HAI rates. The survey also signaled that patient empowerment will play an increasingly important role in the HAI issue, with four in five consumers saying they would ask hospital staff to wash their hands, if prompted to do so.

As many as 2 million patients acquire infections in U.S. hospitals each year, resulting in 90,000 deaths annually, according to the Centers for Disease Control and Prevention (CDC), and the CDC has said hand hygiene is the single most important factor in reducing HAIs. In fact, infection control programs that include hand hygiene compliance measurement can reduce HAIs by one-third.

According to the survey:

  • Cleanliness tops the list of factors consumers consider when choosing a hospital. Survey respondents were asked how important each of a list of factors would be if they had to choose a new hospital right now. The vast majority (94 percent) rate "clean" as very important to their decision. Relatedly, 85 percent consider low infection rates very important in hospital selection.
  • Access to hospital-infection-rate data will impact patients' choices. The vast majority (93 percent) of consumers say knowing infection rates for a hospital or doctor would influence their selections. Nearly nine in ten (87 percent) say higher-than-average infection rates would be a very important reason to avoid a hospital. Four in five (79 percent) say lack of cleanliness would be a very important reason to avoid a hospital.
  • Cleanliness outranked the second most important factor, insurance coverage (88 percent), proximity (49 percent), and several other factors as reasons sited for selecting a particular hospital.