A damning new report has laid bare the stark disparities in hospital cleanliness across the United States, identifying the states where patients are at the greatest risk of contracting a deadly infection during their stay.
The States with the Dirtiest Hospitals
Healthcare staffing platform Nursa conducted a comprehensive analysis, sifting through nearly 800,000 reports of hospital-acquired infections and approximately 13,000 inspections focused on hospital hygiene. The findings are alarming, revealing a direct link between unclean facilities and patient safety.
Delaware has been ranked as having the nation's dirtiest hospitals, scoring a worrying 9.6 out of 10 on a scale where a higher score indicates worse conditions. With only 19 facilities in the state, Delaware recorded nearly 2,800 hospital-acquired infections in 2023 alone. Patient feedback was equally concerning, with local hospitals receiving just two out of five stars for cleanliness. One in eight patients reported that their room and bathroom were not consistently clean.
Washington DC followed closely behind with a score of 9.4 out of 10. The district had 33 government inspections flagging cleanliness issues and the nation's highest rate of patient dissatisfaction at 16 percent. Alabama completed the top three worst states, scoring 9.1 out of 10.
The Human and Financial Cost of Hospital Infections
Hospital-acquired infections are a critical public health issue, often stemming from dirty equipment and surfaces where dangerous pathogens linger. These germs then spread to vulnerable patients with compromised immune systems. Common infections include urinary tract infections from unsanitary catheters and pneumonia from ventilators. More severe and often antibiotic-resistant infections include methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff), and sepsis.
The scale of the problem is immense. Every year, about 1.7 million Americans suffer a hospital-acquired infection, leading to almost 100,000 deaths. At any given time, roughly one in every 31 hospital patients is battling such an infection. These figures saw a dramatic surge during the Covid-19 pandemic, with a CDC analysis noting a rise of up to 47 percent, largely attributed to the increased use of high-risk equipment like ventilators.
The financial burden is equally staggering, costing the US healthcare system between $28 billion and $45 billion annually. A recent report from the University of Utah added further concern, revealing that rates of the hospital bacteria infection Clostridium difficile are spreading in US hospitals three times faster than experts had previously believed.
A Glimmer of Hope and a Stark Contrast
Amid the troubling data, there was a slight improvement in 2023, with hospital-acquired infections declining by 11 to 15 percent compared to the previous year. Furthermore, the study highlighted Utah as a beacon of better practice, home to the nation's cleanest hospitals. Utah scored a low 2.7 out of 10 on the dirtiness scale across its 69 facilities, with patients awarding an average cleanliness rating of 3.8 out of five stars.
Experts suggest that demographic factors may partly explain the stark contrast between states like Delaware and Utah. Delaware has a rapidly aging population, with one in four residents over 60—a figure expected to grow. An aging immune system and higher prevalence of conditions like cancer and diabetes increase infection risk. Conversely, Utah has the smallest portion of residents over 60 and lower rates of immune-suppressing behaviours like smoking.
