Suitability of elderly adult hospital readmission rates for profiling readmissions in younger adult and pediatric populations

Emily M Bucholz 1 2, Sara L Toomey 2 3, Neel M Butala 2 4, Alyna T Chien 2 3, Robert W Yeh 5, Mark A Schuster 2 3 6

Affiliations

PMID: 32037552
PMCID: PMC7080390 (available on 2021-04-01)
DOI: 10.1111/1475-6773.13269

Free PMC article

Abstract

Objective: To determine the correlation between hospital 30-day risk-standardized readmission rates (RSRRs) in elderly adults and those in nonelderly adults and children.

Data sources/study setting: US hospitals (n = 1760 hospitals admitting adult patients and 235 hospitals admitting both adult and pediatric patients) in the 2013-2014 Nationwide Readmissions Database.

Study design: Cross-sectional analysis comparing 30-day RSRRs for elderly adult (≥65 years), middle-aged adult (40-64 years), young adult (18-39 years), and pediatric (1-17 years) patients.

Principal findings: Hospital elderly adult RSRRs were strongly correlated with middle-aged adult RSRRs (Pearson R2 .69 [95% confidence interval (CI) 0.66-0.71]), moderately correlated with young adult RSRRs (Pearson R2 .44 [95% CI 0.40-0.47]), and weakly correlated with pediatric RSRRs (Pearson R2 .28 [95% CI 0.17-0.38]). Nearly identical findings were observed with measures of interquartile agreement and Kappa statistics. This stepwise relationship between age and strength of correlation was consistent across every hospital characteristic.

Conclusions: Hospital readmission rates in elderly adults, which are currently used for public reporting and hospital comparisons, may reflect broader hospital readmission performance in middle-aged and young adult populations; however, they are not reflective of hospital performance in pediatric populations.

Keywords: age; readmission.