KAISER FOUNDATION HOSPITAL – SACRAMENTO
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 | 16.9% | 18 to 34 | 9.1% | 1.90 |
|
2.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 50 to 64 | 14.7% | 18 to 34 | 9.1% | 1.60 |
|
3.
HCAI 30-Day readmission
|
Expected Payor | Medicare | 17.1% | Private | 11.5% | 1.50 |
|
4.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 35 to 49 | 12.7% | 18 to 34 | 9.1% | 1.40 |
|
5.
HCAI 30-Day readmission
|
Expected Payor | Medicaid | 14.8% | Private | 11.5% | 1.30 |
|
6.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Black or African American | 16.9% | Hispanic or Latino | 13.4% | 1.30 |
|
7.
HCAI 30-Day readmission
|
Race and/or Ethnicity | White | 16.0% | Hispanic or Latino | 13.4% | 1.20 |
|
8.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Multiracial and/or Multiethnic (two or more races) | 15.6% | Hispanic or Latino | 13.4% | 1.20 |
|
9.
HCAI 30-Day readmission MHD
|
Sex Assigned at Birth | Male | 16.2% | Female | 15.6% | 1.00 |
|
10.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Asian | 13.4% | Hispanic or Latino | 13.4% | 1.00 |
2. Equity Plan
Kaiser Permanente (KP) Sacramento Medical Center is committed to reducing disparities identified in the HCAI Top 10 Disparities Report. The data shows that unplanned 30-day readmissions disproportionately affect patients aged 35–49, 50–64, and 65+, Medicare and Medicaid beneficiaries, and ethnicities of White, Multiracial, and Black/African American patients. Additional disparities exist for male surgical inpatients with serious but treatable conditions, and male patients with behavioral health diagnoses.
A multidisciplinary Readmission Team reviews cases weekly, identifying inequities and implementing interventions such as culturally tailored education, interpreter support, early follow-up, and discharge planning informed by Social Determinants of Health (SDOH). Our goal is to reduce the HCAI all-cause unplanned 30-day hospital readmission rate by 5% over the next year.
A Quality Health Team addresses surgical mortality disparities among male patients by strengthening perioperative protocols, expanding monitoring of high-risk patients, implementing early escalation pathways, and providing staff education on bias reduction. In addition, the Senior Surgical Care Program aims to deliver care that aligns with the goals of seniors aged 75 and above who are considering inpatient surgery. The goal is a 5% reduction in surgical mortality disparities by September 30, 2026.
For behavioral health, KP Sacramento reinforces discharge planning, strengthens linkages to outpatient follow-up, and partners with community-based providers to expand access to culturally responsive services. Equity efforts are supported through ongoing investment in culturally responsive workforce training and sustained community partnerships that address housing, food insecurity, utilities, transportation barriers, and interpersonal violence. Outcomes are reviewed quarterly, stratified by age, race/ethnicity, language, sex, language and payer, with corrective action when goals are not met.
The Regional Age Friendly Hospital System (AFHS) Core Team will be leading and supporting all 21 KP NCAL facilities to achieve IHI AFHS Level 1 Recognition status by the end of 2025 and then IHI AFHS Level 2 Recognition status by the end of 2026. The team will also ensure that all facilities have protocols in place to affirmatively attest to receive full credit for all 5 Domains of the CMA AFHS Measure by May 2025. This will position our hospitals to consistently and reliably provide high-quality care to all hospitalized elderly patients.
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.