RADY CHILDREN’S HOSPITAL ORANGE COUNTY

1. Top 10 Disparities

2. Equity Plan

Overview and Findings
The Orange Hospital analysis of AB 1204 equity measures for Calendar Year 2024 reveals notable disparities by race/ethnicity, payor type, age, sex assigned at birth, and preferred language.

Key Disparities & Insights
All-Cause Unplanned 30-Day Hospital Readmission Rate
- Race/Ethnicity: Asian patients showed the lowest readmission rate at 8.8% compared to White patients at 15.2% and Hispanic or Latino patients at 15.0%, both reflecting a rate ratio (RR) of 1.7.
- Payor: Patients with private insurance showed a lower readmission rate of 12.7%, compared to patients insured through Medicaid at 15.1% (RR 1.2).
- Sex Assigned at Birth: Male patients had a slightly lower readmission rate of 14.0% compared to female patients at 14.9% (RR 1.1).

Pediatric Experience Survey with Scores of Willingness to Recommend the Hospital
- Language: Families of patients preferring Spanish reported the highest willingness-to-recommend rate at 91.8% compared to families of patients preferring English at 85.9% (RR 1.1).
- Payor: Families of patients with Medicaid insurance showed the highest willingness-to-recommend rate with a rate of 89.7%, compared to families of patients insured through private insurance at 84.4% (RR 1.1).
- Race/Ethnicity: Families of White patients showed the highest willingness-to-recommend rate of 87.3% compared to families of Black or African American patients at 80.8% and Asian patients at 82.6% (both RR 1.1).
- Age: Families of patients aged 10-14 years showed the highest willingness-to-recommend rate of 89.0% compared to families of patients aged 0-4 years at 84.6% (RR 1.1) and 15 years and older at 88.3% (RR 1.0).

Strategic Interventions
1.Data & Predictive Modeling
- Continue enterprise-wide demographic and condition data collection for deeper analysis.
- Conduct multivariate studies to clarify observed discrepancies.
- Refine risk models to include social factors and language to identify high-risk discharges.
2. Workforce & Governance
- Socialize disparity data through venues such as medical staff town halls, nursing forums, and leadership committee .
- Build a system-wide learning network to share effective interventions and data insights.
- Embed equity metrics into Quality and Safety dashboards and scorecards.
3. Leverage Trust to Drive Outcomes
- Launch a patient experience survey campaign to strengthen WTR among groups experiencing disparities.
- Use high and low WTR to invite families to co-design, highlighting successful family stories, understanding what can be improved and activating community advocates to increase organizational health literacy.
4. Targeted Discharge & Follow-Up Pathways
- Improve discharge education with health literacy strategies and interpretation tools, including “Say-It-Simply, ” teach-back, and visual tools.
- Promote the free CHOC Nurse Line , available with Spanish-speaking staff and interpreter services, to support post-discharge guidance to reduce avoidable readmissions.
5. Patient-Focused Chronic Care Strategies
- Develop simplified care plans and digital reminders to support adherence.
- Engage families and schools in chronic disease management, including adolescent transition supports.
6. Community & System Partnerships
- Connect families with community health workers and navigators for appointment access, care adherence, and home support.
- Leverage school and community partnerships for education and linkage to care, including social needs.

Measurement & Targets
- Implement quarterly equity dashboards tracking 30-day readmissions and WTR by race, language, payor, age, sex assigned at birth and diagnosis.
- Adopt strategies to reduce the readmission gap between families insured through Medicaid and private payors in the next reporting cycle while maintaining or improving WTR among high-reporting groups.

Conclusion
CHOC Children’s Hospital faces both a challenge and an opportunity in the finding that patient groups with elevated readmission rates also report high willingness-to-recommend (WTR). This dynamic suggests that trusted relationships already exist and that families are receptive, engaged, and willing partners in their care. The task ahead is to translate that trust into effective, equitable transitions of care. By strengthening discharge planning, enhancing health literacy, and expanding targeted follow-up and navigation supports, CHOC can leverage these positive relationships to address underlying access barriers. Coupled with data-driven insights, community partnerships, and accountable governance, these system-level interventions position CHOC to reduce disparities while sustaining high-quality, patient-centered experiences for all populations.

3. Structural Measures

4. Web Address for Equity Report

https://choc.org/about/hospital-equity-measures-report

5. Download Equity Measures Report

Click on the link below to download the equity measures report.

6. Looking for Related Reports?

• Community Benefit Plan
• Hospital Supplier Diversity Plan
• Hospital Profile
• Hospital Fair Billing Policies