A majority of Americans (55.5%) do not feel cruise ships are equipped to handle serious medical emergencies, a new study reveals.

This represents a change from last year, when 60% of US consumers believed cruise ships could handle such emergencies.

The survey by travel insurance provider Allianz Global Assistance was conducted during the height of the wave booking season, which runs from January to March in the US.

When asked for their estimate of the cost of an air ambulance evacuation to the US from Mexico or the Caribbean, a quarter of respondents underestimated the cost at up to $10,000.

Another quarter of respondents correctly estimated cost as coming in between $10,001 and $20,000.

Among other findings, 38% of consumers surveyed thought that travel insurance is more important when booking a cruise than it is for other types of travel.

The poll also found that more than two-thirds of respondents would prefer to spend all or most of their time exploring their destination instead of staying aboard the cruise ship, a slight increase from last year.

However, safety concerns with the destination were still the top reason (35.7%) why US cruisers would be hesitant to disembark at port.

Other reasons include disinterest in the destination (18.4%), fear of not getting back on the ship in time (14.1%), previously having visited the destination (11.4%), taking advantage of all-inclusive food and drinks on board (9.7%), not having pre-booked an off-board activity (7%) and lack of internet/mobile connectivity (3.7%).

The wave season survey also analysed trends such as themed cruises, finding that almost a third were not interested in food, pop culture or music-themed cruises.

Fewer respondents are interested in adventure or expedition cruises to places like Alaska over sun and beach destinations compared to last year (43.8%, down from 48.9%).

Almost three quarters (74.2%) of those surveyed expressed interest in river cruises over ocean cruises thanks to more scenic routes (21.5%), lack of waves (13.5%), easier disembarking (13.4%), smaller ship sizes (12.2%), shore excursions being included in the price (9.8 %) and socialising opportunities (3.8%).

An Allianz spokesman said: “While cruising has become an increasingly popular vacation choice among Americans, consumers are wary of cruise lines’ ability to care for them during a medical emergency.

“Our wave season survey shows that cruisers have become more sophisticated and understand that most ships will disembark seriously ill or injured passengers in the closest port, regardless of whether the closest medical facilities can provide an appropriate level of care.

“Smart cruisers are covering themselves with travel insurance in the event that they must be medically evacuated to a facility that is properly equipped to treat them.”