New horizons in the analysis of hospital readmissions of older adults.

This short communication highlights analytical methods that can be usefully applied to the problem of hospital readmissions of older adults. The limitations of the models currently used in studies of hospital readmissions are described. In summary, analyses of hospital readmissions face two important methodological and statistical problems not accounted for by these currently used statistical models: the potential recurrence of readmissions, and death, a terminal event which absorbs the readmission process. Not addressing the issue raised by recurrent events and terminal event generates biased estimates. We discuss an approach for the analysis of hospital readmission risk and death in the same framework. Understanding the features of this kind of approaches is essential at a time when high-quality data on hospital readmission in older patients are becoming available to a large number of researchers. Models adapted for the analysis of recurrent and terminal events are presented, and their application to studies of hospital readmission are explained, with reference to two cohorts of several thousand older individuals.