CITY OF HOPE HELFORD CLINICAL RESEARCH HOSPITAL
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) | 18 to 34 | 40.7% | 65 and older | 25.2% | 1.60 |
|
2.
HCAI 30-Day readmission
|
Expected Payor | Medicaid | 33.6% | Medicare | 25.6% | 1.30 |
|
3.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 35 to 49 | 31.3% | 65 and older | 25.2% | 1.20 |
|
4.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Hispanic or Latino | 31.1% | White | 25.5% | 1.20 |
|
5.
HCAI 30-Day readmission MHD
|
Sex Assigned at Birth | Male | 32.4% | Female | 26.9% | 1.20 |
|
6.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Asian | 30.5% | White | 25.5% | 1.20 |
|
7.
HCAI 30-Day readmission NOBH
|
Sex Assigned at Birth | Male | 29.3% | Female | 26.1% | 1.10 |
|
8.
HCAI 30-Day readmission
|
Sex Assigned at Birth | Male | 29.8% | Female | 26.7% | 1.10 |
|
9.
HCAI 30-Day readmission
|
Expected Payor | Private | 28.4% | Medicare | 25.6% | 1.10 |
|
10.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 50 to 64 | 26.6% | 65 and older | 25.2% | 1.10 |
2. Equity Plan
Disparity 1, 3, 5, 7, 9, 10
List Measurable Objectives:
Leverage Epic Risk of Unplanned Readmission model to assess our patients 18-34, 35-49, 50-64, male patients with and without mental health disorder and patients with private insurance. Create a workflow that ensures patients 18-34, 35-49, 50-64, male patients with and without mental health disorder and patients with private insurance are contacted within 14 days.
Provide Specific Timeframes:
Leverage Epic Risk of Unplanned Readmission model to assess our patients 18-34, 35-49, 50-64, male patients with and without mental health disorder and patients with private insurance within 24 months. Create a workflow that ensures patients 18-34, 35-49, 50-64, male patients with and without mental health disorder and patients with private insurance are contacted within 14 days within 24 months.
Population Impact — Disparity 1
Adults 18 to 34 experience higher unplanned readmissions, often due to limited care navigation, inconsistent follow-up, and lower engagement with discharge instructions.
Population Impact — Disparity 3
Patients aged 35—49 often balance cancer treatment with employment and family responsibilities. These competing priorities increase the risk of missed follow-up appointments and medication non-adherence.
Population Impact — Disparity 5
Males with mental health disorders experience higher readmission rates, often due to gaps in behavioral health integration, limited engagement in post-discharge care, and social stigma impacting follow-up adherence.
Population Impact — Disparity 7
Males without behavioral health diagnoses still exhibit higher readmission rates, often linked to lower engagement in post-discharge care, reduced adherence to treatment plans, and social factors such as limited caregiver support.
Population Impact — Disparity 9
Patients with private insurance often experience fragmented care networks, prior authorization delays, and complex benefit designs.
Population Impact — Disparity 10
Patients aged 50—64 represent a significant portion of the oncology population and often experience complex treatment regimens, high symptom burden, and competing responsibilities such as employment and caregiving.
Disparity 2, 4, 6, 8
List Measurable Objectives:
Identify the Social Determinants of Health (SDOH) that most influence 30-day unplanned readmission for Medicaid, Hispanic or Latino, Asian and male patients assigned at birth.
Construct a workflow where our patient resource coordinators (PRCs) address the SDOH identified to most influence the 30-day readmission for Medicaid, Hispanic or Latino, Asian and male patients assigned at birth.
Provide Specific Timeframes:
Identify the SDOH that most influence 30-day unplanned readmission for Medicaid, Hispanic or Latino, Asian and male assigned at birth patients within 24 months.
Construct a workflow where the PRCs address the SDOH identified to most influence the 30-day readmission for Medicaid, Hispanic or Latino, Asian and male patients assigned at birth within 24 months.
Population Impact — Disparity 2
Medicaid patients may face transportation, care coordination, language, and resource barriers that contribute to readmissions.
Population Impact — Disparity 4
Hispanic and Latino patients face higher readmission rates compared to White patients. Contributing factors include language barriers, health literacy challenges, and cultural differences in navigating complex care systems.
Population Impact — Disparity 6
Asian patients may experience cultural hesitancy, language barriers, and underreporting of symptoms.
Population Impact — Disparity 8
Male patients experience slightly higher readmission rates, which may be influenced by lower engagement in care transitions, reduced adherence to discharge instructions, and social factors such as limited caregiver support.
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.