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Comparative Study
. 2020 Apr;55(2):277-287.
doi: 10.1111/1475-6773.13269. Epub 2020 Feb 9.

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
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Comparative Study

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

Emily M Bucholz et al. Health Serv Res. 2020 Apr.

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.

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Figures

Figure 1
Figure 1
Pearson correlation coefficients and weight Cohen's kappa statistics comparing (A) pediatric, young adult, and middle‐aged adult RSRRs to elderly adult RSRRs, and (B) age decile RSRRs to age ≥70 y RSRRs. Comparisons between pediatric and elderly adult RSRRs in (A) and between RSRRs for patients aged 1‐9 y and 10‐19 y with RSRRs for patients aged ≥70 y in (B) are performed in pediatric/adult sample (n = 287 hospitals). All other comparisons were performed in adult sample (n = 1760)
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References

    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee‐for‐service program. N Engl J Med. 2009;360:1418‐1428. - PubMed
    1. Joynt KE, Jha AK. A path forward on Medicare readmissions. N Engl J Med. 2013;368:1175‐1177. - PubMed
    1. Centers for Medicare and Medicaid Services . Hospital compare. 2016. https://www.medicare.gov/hospitalcompare/search.html.Accessed April 12, 2017.
    1. Srivastava R, Keren R. Pediatric readmissions as a hospital quality measure. JAMA. 2013;309:396‐398. - PubMed
    1. Dharmarajan K, Hsieh AF, Lin Z, et al. Diagnoses and timing of 30‐day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. JAMA. 2013;309:355‐363. - PMC - PubMed

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