The pros and cons of single-patient rooms

While a prominent professor at the University of Aberdeen said single rooms in hospitals for all patients are necessary to prevent and contain hospital-related infections, a hospital consultant argued that their positive effects are unproven.

"Single rooms increase patients' privacy, dignity, and confidentiality [and] they give patients more control over their immediate environment," Hugh Pennington, emeritus professor of bacteriology, wrote in the British Medical Journal. In addition, a recent Canadian study indicated that switching from multibed units to single rooms correlated with a reduction in infections and shorter stays, Pennington wrote.

Pennington also cited the reemergence of hospital-based tuberculosis transmission in the early 1990s, saying single rooms are essential to prevent such infections. "A patient with undiagnosed disease in a single room is less likely to infect others," he wrote.

The Scottish government recently called for all new hospitals to have only single rooms, using similar reasoning. "Single rooms provide a better and safer environment for patients and will enhance their experience during their stay in hospital," Scottish Health Secretary Alex Neil said in a statement in June. "More importantly, single rooms make a significant contribution towards reducing the patient's risk of contracting and passing on an avoidable infection."

However, not everyone agrees with Pennington on the issue. The isolation of single rooms can significantly worsen a patient's stay, Chris Isles, consultant physician at Dumfries and Galloway Royal Infirmary, wrote in a counterpoint in the same BMJ article. Isles argued patients should have a choice, citing a 2008 Scottish government survey in which only 41 percent of adults said they would definitely prefer a single room. "The prospect of spending several days alone in a single room clearly does not appeal to everyone," he wrote.

Isles also questioned whether single rooms clearly affect infection rates. Referring to the same Canadian study, he noted that while it found the risk of Clostridium difficile infection increases 11 percent with each new roommate, the absolute risk of infection was only 0.5 percent. "11% of nothing is nothing, and 11% of 0.5% is not very much more," he wrote.

A recent New York Times editorial claimed while the trend toward single rooms and other hotel-like amenities in hospitals has some medical benefits, it is geared more toward marketing than improved care, FierceHealthcare previously reported.

To learn more:
- here's Pennington and Isles' point-counterpoint
- read the Scottish government's statement

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