School of Public Health

Do private rooms lower the risk of hospital-acquired infections?


Posted Date: August 6, 2018

By Sally Crocker

Liam Oneill

Dr. Liam O’Neill

Private hospital rooms may save lives by reducing the risk of a dangerous type of hospital-acquired infection, according to UNT Health Science Center researchers in a new study published in PLOS ONE.

Liam O’Neill, PhD, Associate Professor of Health Behavior and Health Systems at the UNTHSC School of Public Health, who led the study with Frank Rosinia, MD, UNTHSC Professor and Executive Vice President for Strategy and Performance, and doctoral student Sae-Hwan Park, sought to understand the impact of private rooms on patient safety events and preventable complications, such as central line infections.

Examining discharge records for more than one million inpatients across 335 Texas hospitals, the research team found that patients who stayed in bay (double occupancy) rooms had 64% more central line infections than patients who stayed in private rooms. After adjusting for patient characteristics and risk factors, such as race, ethnicity, age, sex and comorbidities, the study’s authors found that patients who stayed in bay rooms had a 21% increase in the relative risk of a central line infection compared to patients assigned to private rooms.

Central line-associated bloodstream infections are those acquired through central venous catheters. Due to the central line’s proximity to the heart, such infections are both costly and extremely dangerous.

The mortality rate for patients with central line infections is 12-25 percent, accounting for about 5,000-10,000 preventable deaths each year.

“At the hospital level, taking overall facility design into account, a 10% increase in private rooms was associated with an 8.6% decrease in central line infections, regardless of individual room assignments. This suggests that there may be some positive externalities at work that benefit all patients, not just those assigned to private rooms.”

The study also found significant racial and ethnic differences in the likelihood of being assigned to a private room. Compared with non-Hispanic whites, African-Americans were 1.63 times more likely, and Hispanics were 1.44 times more likely, to stay in a bay room. Most of these differences appear to be driven by a hospital’s geographic location.

South and west of San Antonio, bay rooms are still predominant.

By contrast, the “Texas Triangle” – defined nationally as one of the country’s mega regions, bordered by the four main cities of Houston, Dallas-Fort Worth, San Antonio and Austin – has seen significant population growth and new hospital construction over the past decade, with the majority of hospital rooms in the region now private.

The researchers noted that hospitals with mostly private rooms also employed more nurses and had shorter lengths of stay with fewer in-hospital transfers. Each of these factors is also associated with fewer hospital-acquired infections.

“Private hospital rooms have numerous other benefits that are harder to quantify,” Dr. O’Neill said, “such as more privacy, reduced noise, fewer dietary and medication mix-ups, and reduced stress.”

While this study focused on only one aspect of private rooms, the research team plans to study other aspects in the future, he said.

“We hope that our findings will start to change the conversation in hospital board rooms from how much will private rooms cost to how many lives will they save,” Dr. O’Neill said.