DOCTORS HOSPITAL OF RIVERSIDE
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 | 17.8% | 18 to 34 | 4.1% | 4.30 |
|
2.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 50 to 64 | 16.2% | 18 to 34 | 4.1% | 3.90 |
|
3.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 35 to 49 | 9.3% | 18 to 34 | 4.1% | 2.30 |
|
4.
HCAI 30-Day readmission
|
Expected Payor | Medicare | 18.8% | Medicaid | 9.6% | 2.00 |
|
5.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Black or African American | 19.1% | Hispanic or Latino | 12.3% | 1.50 |
|
6.
HCAI 30-Day readmission NOBH
|
Sex Assigned at Birth | Male | 15.3% | Female | 10.2% | 1.50 |
|
7.
HCAI 30-Day readmission
|
Sex Assigned at Birth | Male | 15.7% | Female | 11.7% | 1.30 |
|
8.
HCAI 30-Day readmission
|
Expected Payor | Private | 11.6% | Medicaid | 9.6% | 1.20 |
|
9.
HCAI 30-Day readmission
|
Race and/or Ethnicity | White | 13.3% | Hispanic or Latino | 12.3% | 1.10 |
2. Equity Plan
Population Impact:
-Age related disparities. Adults 35-65+ experience higher unplanned readmissions compared to patients 18-34
-Race related disparities. Black/African American and White patients experience higher unplanned readmissions compared to Hispanic/Latino patients.
-Payer related disparities. Medicare and private payer patients experience higher unplanned readmissions compared to Medicaid patients.
-Sex related disparities. Male and male stratified by behavioral health diagnosis experience higher unplanned readmission compared to female patients.
Doctor's Hospital of Riverside is committed to effective, quality care for all patients. We committed to reducing disparities in HCAI all-cause unplanned 30-day readmission rates across age, payer, race/ethnicity and sex groups identified in the hospital's disparity report. In order to address these disparities, the hospital interventions will include early case management involvement, discharge education using teach-back, clear medication lists and shared decision making prior to discharge. Follow-up appointments will attempted to be scheduled before discharge for all high-risk age groups. Early post-discharge outreach will serve to assess symptoms, confirm medication access and reinforce discharge instructions.
Additionally, the facility has convened a multidisciplinary committee to review all readmissions and identify opportunities to prevent future readmissions. The committee evaluates impacts of social determinants of health such as limited access to transportation and follow-up care, higher behavioral health comorbidity in the 35-49 group, increased function limitations in the 65+ group and complex medication regimens. The multidisciplinary committee is spearheaded by the Readmissions Coordinator who conducts several activities to further reduce readmissions including discharge phone calls and educational rounds on patients that are high risk for readmissions. Additionally, collaborative meetings are conducted with the post-acute care facilities that we partner with in order to streamline coordinated care and reduce readmissions. All of these efforts incorporate the social lens of race, ethnicity, sex, payer and age.
Patients will continue to be screened for social determinates of health upon admission and receive prompt and appropriate resources based on the screening.
Measurable Objectives:
-Reduce 30-day readmission rate ratio for ages 65+ from 4.3 to 3.5
-Reduce 30-day readmission rate ratio for ages 50-64 from 3.9 to 3.0
-Reduce 30-day readmission rate ratio for ages 35-49 from 2.3 to 2.5
-Reduce 30-day readmission rate ratio for Medicare payer from 2.0 to 1.0
-Reduce 30-day readmission rate ratio for Black or African American patients from 1.5 to 1.0
-Reduce 30-day readmission rate ratio for Male patients from 1.5 (stratified by behavioral health diagnosis) and 1.3 to 1.0
-Reduce 30-day readmission rate ratio for Private payer patients from 1.2 to 1.0
-Reduce 30-day readmission rate ratio for White patients from 1.1 to 1.0
Specific Timeframes: Begin interventions Q1 2026 and monitor annually
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.