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

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 R (2) .69 [95% confidence interval (CI) 0.66‐0.71]), moderately correlated with young adult RSRRs (Pearson R (2) .44 [95% CI 0.40‐0.47]), and weakly correlated with pediatric RSRRs (Pearson R (2) .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.