ASSOCIATION RULES IN HEART FAILURE READMISSION RATES AND PATIENT EXPERIENCE SCORES.

Objective: Thirty-day readmission rates are closely monitored in today's healthcare ecosystem to prevent higher-than-average rates in inpatient settings. Excess readmission rates result in decreased reimbursement for healthcare facilities. Additionally, feedback from patients about their hospital experience may indicate areas of improvement for healthcare facilities. This feedback is a national survey that collects data on patient experience through a standardized survey called Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The objective of this study is to identify significant patterns between readmission rates and HCAHPS survey data through the application of association rules.

Materials and methods: Publically accessible HCAHPS survey data and 30-day readmission rates provided by the Centers for Medicare and Medicaid Services (CMS) were utilized for this study. Through the implementation of association rules using SAS Enterprise Miner, significant rules were identified in the data.

Results: Association rules were developed in SAS Enterprise Miner and produced three significant rules associated with high heart failure (HF) readmission as the right-hand rule. The rules indicated that a high pneumonia readmission, a low cleanliness star rating, and a low medication communication star rating were associated with a high readmission rate for heart failure.

Conclusions: The rules provided strong associations between HCAHPS star ratings and determining a high readmission rate for HF. It was interesting to find that pneumonia readmissions exist as well with a high HF readmission. Hospitals should work on improving their star ratings for the HCAHPS domains identified and work on lowering pneumonia readmissions to lower their HF readmissions.