ADVENTIST HEALTH TWIN CITIES
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
|
Age (excluding maternal measures) | 65 and older | 15.2% | 18 to 34 | 5.6% | 2.70 |
|
2.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 50 to 64 | 13.0% | 18 to 34 | 5.6% | 2.30 |
|
3.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 35 to 49 | 11.4% | 18 to 34 | 5.6% | 2.10 |
|
4.
HCAI 30-Day readmission
|
Expected Payor | Medicare | 15.3% | Private | 7.9% | 1.90 |
|
5.
HCAI 30-Day readmission
|
Expected Payor | Medicaid | 11.8% | Private | 7.9% | 1.50 |
|
6.
HCAI 30-Day readmission NOBH
|
Sex Assigned at Birth | Male | 14.3% | Female | 10.5% | 1.40 |
|
7.
CMQCC breast milk feeding
|
Race and/or Ethnicity | Hispanic or Latino | 61.4% | White | 76.7% | 1.20 |
|
8.
HCAI 30-Day readmission
|
Race and/or Ethnicity | White | 13.8% | Hispanic or Latino | 11.3% | 1.20 |
|
9.
HCAI 30-Day readmission
|
Sex Assigned at Birth | Male | 14.2% | Female | 12.3% | 1.20 |
|
10.
CMQCC breast milk feeding
|
Expected Payor | Medicaid | 64.6% | Medicaid | 64.6% | 1.00 |
2. Equity Plan
Our hospital addresses disparities in readmission rates and breastfeeding practices through a comprehensive equity plan grounded in data and measurable goals. These gaps affect patients by age, payor type, gender, and ethnicity, and our strategies include phased timelines and success metrics.
Older adults 65 and above have a 14.5% readmission rate compared to 5.3% for younger patients aged 18 to 24: leading to a rate ratio of 2.7. These patients often face chronic conditions and mobility challenges. Through chronic disease management, caregiver engagement, and coordination of care, we will bring this population's readmissions rate to below 10% within 12 months.
Patients aged 50–64 experienced readmission rates of 12.8% compared to the readmission rates of younger adults at 5.3%. To reduce these rates below 10% by the end of 2026, we will focus on preventative care, education, and medication reconciliation. Patients aged 35–49 had readmission rates of 10.6%, compared to the readmission rates of younger adults at 5.3%. This population will benefit from initiating flexible scheduling for follow-up care, along with telehealth services, aiming at reducing readmission rates to 5% within 12 months.
In addition to age-based disparities, we observed payor-based disparities. Medicare patients experienced readmission rates of 14.5% compared to 7.5% for privately insured patients. In an effort to reduce readmission rates below 10% by the end of 2026, we will focus on strengthening discharge planning and care coordination for Medicare patients. Medicaid patients had readmission rates of 11.5% versus 7.5% for privately insured patients. We will expand social determinants screening and follow up coordination for Medicaid patients to reduce readmission rates below 10% by the end of 2026.
Gender disparities include men without behavioral health diagnoses at 13.5% compared to 10.3% for women, and overall male patients at 13.6% versus 11.8%. Outreach and education programs will be launched, aiming at reduced readmission rates for male patients below 10% within 12 months.
White patients have a 13.2% readmission rate compared to 10.3% for Hispanic patients. We will strengthen care transitions and rural outreach, closing the gap and reducing readmission rates 10% within 12 months.
Maternal care disparities are notable among Hispanic mothers, whose exclusive breastfeeding rate is 61.4% compared to 76.7% for White mothers. We will increase this to 70% within 18 months through culturally and linguistically appropriate lactation support and education. Patients with "Other" payor types had exclusive breastfeeding rates of 61.9% compared to 64.6% for Medicaid patients. We will aim to improve these rates to 65% within 12 months through improved postpartum education, culturally appropriate lactation support, and resource access.
Quarterly reviews will ensure accountability and allow adjustments. By focusing on education, care coordination, and culturally responsive practices, we aim to eliminate these gaps and deliver equitable care for all patients, regardless of age, race, gender, or socioeconomic status.
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.