Preferences for Infection Prevention in Hospital-Acquired Infections.

Abstract

Hospital-acquired infections worsen health care outcomes and increase costs. The decision-making process guiding selection of infection prevention practices for hospital-acquired infections is not well understood; understanding how health care professionals prioritize infection prevention practices is critical for guiding efficient and equitable implementation. To determine the characteristics of infection control practices that affect health care professional decision-making. This survey study was a discrete choice experiment conducted between February 27 and March 27, 2025, with data analyzed from March 28 to June 3, 2025. Health care professionals who had participated in infection prevention and control decision-making identified through authorship in related journals were eligible to participate. Attributes were identified through literature review and expert consultation. Data were analyzed using mixed logit and latent class models. Scenario and relative attribute importance analyses were performed to explore heterogeneity in preferences. Respondents chose between infection control practices varying in 4 attributes: quality of clinical evidence, economic costs and benefits, implementation duration, and additional time required per patient. Preference weights, relative attribute importance, and probability of clinical practice uptake were assessed. A total of 256 respondents were included (161 male [62.9%]), with a median age group of 40 to 49 years (84 [32.8%]) and mostly from high-income countries (160 [62.5%]). Respondents preferred infection prevention practices with strong clinical evidence, shorter implementation durations, lower time burdens, and favorable cost-effectiveness profiles. Two latent classes were identified: evidence seekers in low- and middle-income countries who prioritized high-quality evidence and showed high willingness to adopt practices, and efficiency seekers, including respondents from high-income countries who were more selective and prioritized cost-effectiveness. Economic costs and benefits were consistently the most important attribute across all regions, with marked regional variation in secondary priorities. In this survey study of health care professionals, preferences for infection control practices varied across income levels and geographic regions, reflecting the need for further research to better understand contextual factors influencing infection prevention and control decision-making, particularly in low- and middle-income settings. Strengthening economic evidence and tailored implementation support may promote sustainable adoption.