ADVENTIST HEALTH TULARE
1. Top 10 Disparities
The following table lists the ten largest health equity disparities identified for this reporting period.
Disparities for each hospital equity measure are identified by comparing the rate ratios by stratification groups. Rate ratios are calculated differently for measures with preferred low rates and those with preferred high rates. Rate ratios are calculated after applying the California Health and Human Services Agency's "Data De-Identification Guidelines (DDG)," dated September 23, 2016.
The table below highlights the ten widest health equity disparities identified by hospitals and hospital systems during this reporting period. Measure names have been shortened for display purposes. To view each measure in full, please download the complete Hospital Equity Report using the link below.
| Measure | Stratification | Stratification Group | Stratification Group Rate | Reference Group | Reference Rate | Rate Ratio |
|---|---|---|---|---|---|---|
|
1.
HCAI 30-Day readmission
|
Expected Payor | Medicare | 14.9% | Medicaid | 7.0% | 2.10 |
|
2.
HCAI 30-Day readmission
|
Race and/or Ethnicity | White | 11.0% | Hispanic or Latino | 9.7% | 1.10 |
|
3.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 50 to 64 | 13.0% | 65 and older | 12.2% | 1.10 |
|
4.
HCAI 30-Day readmission
|
Expected Payor | Private | 7.3% | Medicaid | 7.0% | 1.00 |
|
5.
HCAI 30-Day readmission
|
Sex Assigned at Birth | Male | 10.1% | Female | 9.9% | 1.00 |
2. Equity Plan
Adventist Health Tulare HQI Top 10 Disparity* list returned 5 Disparities per HCAI's methodology. The following action plan is carefully developed with an evidenced based, standardized workflow, to identify the needs and tailor the care planning to encompass the individual person.
Disparity #1 Expected Payor: Medicare
Population Impact: The Medicare patient population as a disparity rate of 14.9% in comparison to the reference range of Medicaid with 7.0% for All Cause 30 Day Unplanned Readmissions, creating a return ratio of 2.1.
Disparity #2 Race and Ethnicity: White
Population Impact: The race and ethnicity population, White, has a disparity rate of 11% in comparison to the reference range for Hispanic or Latino of 9.7% for All Cause 30 Day Unplanned Readmissions, creating a return ratio of 1.1.
Disparity #3 Age (excluding maternal measures): 50 to 64
Population Impact: Age (excluding maternal measures): 50 to 64, has a disparity rate of 13.0% in comparison to the 65 and older of 12.2%, creating a return ratio of 1.1.
Disparity #4 Expected Payor: Private
Population Impact: The Medicare patient population as a disparity rate of 7.3% in comparison to the reference range of Medicaid with 7.0% for All Cause 30 Day Unplanned Readmissions, creating a return ratio of 1.0.
Disparity #5 Sex Assigned at Birth: Male
Population Impact: The sex assigned at birth: female has a disparity rate of 10.1% in comparison to the reference range of sex assigned at birth: Female of 9.9%, creating a return ratio of 1.0.
Disparity 1-5 Action Plans:
• Risk stratification by disparity shared with the multidisciplinary committees to help target the specific identified disparities within the readmission reduction performance improvement work.
• Discharge planning to include SDOH screening review and provide interventions to help address the health equity barriers identified to the individual patient.
• Rounding prior to patient discharge by the care management team to confirm communication preference prior to disposition for the care transition team needs.
• Follow up appointments made prior to discharge for all high-risk readmission patients within the provider recommended time frame.
• Meds to Beds program exploration and development to address access barriers for high-risk readmission patients.
• Medication delivery options shared as part of the discharge planning that deliver to surrounding rural communities.
• Follow up calls to help assist with care coordination post disposition are made within 48hrs of discharge for all high-risk readmission patients.
Measurable Objective:
Disparity 1: Reduce All-Cause Unplanned 30-Day Hospital Readmission Disparity Expected Payor: Medicare by 1% within 24 months.
Disparity 2: Reduce All-Cause Unplanned 30-Day Hospital Readmission Disparity Race and Ethnicity: White by 1% within 24 months.
Disparity 3: Reduce All-Cause Unplanned 30-Day Hospital Readmission Disparity Age (excluding maternal measures): 50 to 64 by 1% within 24 months.
Disparity 4: Reduce All-Cause Unplanned 30-Day Hospital Readmission Disparity Expected Payor: Private by 1% within 24 months.
Disparity 5: Reduce All-Cause Unplanned 30-Day Hospital Readmission Disparity Sex Assigned at Birth: Male by 1% within 24 months.
Timeframe: All action plans are in progress with a multidisciplinary committee leading and tracking improvement through the duration of the action plan.
3. Structural Measures
| Centers for Medicare & Medicaid Services (CMS) Hospital Commitment to Health Equity Structural (HCHE) Measure | Yes/No |
|---|---|
Our hospital system strategic plan identifies priority populations who currently experience health disparities |
Yes |
Our hospital system strategic plan identifies healthcare equity goals and discrete action steps to achieve these goals |
Yes |
Our hospital system strategic plan outlines specific resources that have been dedicated to achieving our equity goals |
Yes |
Our hospital system strategic plan describes our approach for engaging key stakeholders, such as community-based organizations |
Yes |
Our hospital strategic plan identifies healthcare equity goals and discrete action steps to achieve these goals |
Yes |
Our hospital system has training for staff in culturally sensitive collection of demographics and/or social determinant of health information |
Yes |
Our hospital system inputs demographic and/or social determinant of health information collected from patients into structured, interoperable data elements using a certified EHR technology |
Yes |
Our hospital system stratifies key performance indicators by demographic and/or social determinants of health variables to identify equity gaps and includes this information in hospital performance dashboards |
Yes |
Our hospital system participates in local, regional or national quality improvement activities focused on reducing health disparities |
Yes |
Our hospital system senior leadership, including chief executives and the entire hospital board of trustees, annually reviews our strategic plan for achieving health equity |
Yes |
Our hospital system senior leadership, including chief executives and the entire hospital board of trustees, annually reviews key performance indicators stratified by demographic and/or social factors |
Yes |
4. Web Address for Equity Report
5. Download Equity Measures Report
Click on the link below to download the equity measures report.
Click on the link below to download all equity measures reports.