RADY CHILDREN’S HOSPITAL SAN DIEGO
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
|
Expected Payor | Private | 9.3% | Medicaid | 4.5% | 4.10 |
|
2.
HCAI 30-Day readmission
|
Race/Ethnicity | Multiracial and/or Multiethnic (two or more races) | 15.1% | Asian | 7.3% | 2.10 |
|
3.
HCAI 30-Day readmission
|
Sex Assigned at Birth | Female | 9.8% | Male | 6.9% | 1.40 |
|
4.
HCAI 30-Day readmission
|
Race/Ethnicity | Hispanic or Latino | 8.5% | Asian | 7.3% | 1.20 |
|
5.
Pediatric survey recommend hospital
|
Race/Ethnicity | White | 79.2% | Hispanic or Latino | 90.1% | 1.10 |
|
6.
Pediatric survey recommend hospital
|
Race/Ethnicity | Multiracial and/or Multiethnic (two or more races) | 79.8% | Hispanic or Latino | 90.1% | 1.10 |
|
7.
Pediatric survey recommend hospital
|
Race/Ethnicity | Black or African American | 80.4% | Hispanic or Latino | 90.1% | 1.10 |
|
8.
Pediatric survey recommend hospital
|
Age | 0–4 years | 80.9% | 5–9 years | 89.4% | 1.10 |
|
9.
Pediatric survey recommend hospital
|
Race/Ethnicity | Asian | 83.1% | Hispanic or Latino | 90.1% | 1.10 |
|
10.
HCAI 30-Day readmission
|
Race/Ethnicity | White | 7.9% | Asian | 7.3% | 1.10 |
2. Equity Plan
Our analysis of demographic performance data identified ten areas with measurable differences. Importantly, most of these disparities reflect small rate ratio differences (1.1), indicating that overall care delivery is consistent across populations. These findings reinforce that our system provides high-quality care across all populations, while highlighting opportunities for refinement in specific areas.
Disparity 1: All-Cause Unplanned Readmission Rate – Private Payor vs. Medicaid
Private payor patients demonstrated a higher unplanned readmission rate compared to Medicaid patients. While this difference is modest, we will review discharge planning processes and support for all patients to ensure consistency. Planned actions include strengthening care coordination, expanding telehealth follow-up visits and patient portal engagement for all payor groups, and monitoring readmission trends to identify any emerging patterns.
Disparity 2: All-Cause Unplanned Readmission Rate – Multiracial/Multiethnic vs. Asian
Multiracial and multiethnic patients had a slightly higher readmission rate compared to Asian patients. This variation is small but will be addressed through enhanced discharge education and coordination for families, especially those with complex medical conditions, ensuring access to language and support resources, and continued monitoring to confirm improvement and prevent widening gaps.
Disparity 3: Unplanned 30-Day Readmission Rate – Female vs. Male
Female patients showed a marginally higher 30-day readmission rate than male patients. Planned actions include reviewing clinical pathways for conditions with higher readmission risk to ensure gender-neutral application, reinforcing family engagement strategies during discharge planning, continued monitoring readmission trends as part of our standard quality review.
Disparity 4: All-Cause 30-Day Readmission Rate – Hispanic or Latino vs. Asian
Hispanic or Latino patients had a slightly higher readmission rate compared to Asian patients. Actions will focus on providing appropriate language support and education materials for families, utilizing patient portals and telemedicine to improve follow-up care, and partnering with Population Health team and community resources to address social needs that may impact recovery.
Disparities 5: Pediatric Experience Survey – White vs. Hispanic or Latino population
Differences in patient experience scores across racial and ethnic groups (White, Multiracial/Multiethnic, Black or African American, and Asian) compared to Hispanic patients were minimal, with rate ratios near or at 1.1. Actions being considered are continuing staff and provider training in family-centered communication, optimizing child life services and enhancing our opportunities with real-time feedback tools to identify and address concerns promptly.
Disparities 6: Pediatric Experience Survey – Multiracial/Multiethnic vs. Hispanic or Latino population
Differences in patient experience scores across racial and ethnic groups (White, Multiracial/Multiethnic, Black or African American, and Asian) compared to Hispanic patients were minimal, with rate ratios near or at 1.1. Strategies are the same as for Disparity 5.
Disparities 7: Pediatric Experience Survey – Black or African American vs. Hispanic or Latino population
Differences in patient experience scores across racial and ethnic groups (White, Multiracial/Multiethnic, Black or African American, and Asian) compared to Hispanic patients were minimal, with rate ratios near or at 1.1. Strategies are the same as for Disparity 5.
Disparity 8: Pediatric Experience Survey – Age 0–4 vs. 5–9
Patients aged 0–4 years scored slightly lower on willingness to recommend compared to those aged 5–9 years. Actions being considered include enhancing age-appropriate engagement strategies for younger patients and their families, reviewing access and availability of child life specialists and comfort measures for toddlers as well as monitoring feedback by age group to ensure improvements are sustained.
Disparities 9: Pediatric Experience Survey – Asian vs. Hispanic or Latino population
Differences in patient experience scores across racial and ethnic groups (White, Multiracial/Multiethnic, Black or African American, and Asian) compared to Hispanic patients were minimal, with rate ratios near or at 1.1. Strategies are the same as for Disparity 5.
Disparity 10: All-Cause Unplanned 30-Day Readmission Rate – White vs. Asian
White patients had a slightly higher 30-day readmission rate compared to Asian patients, with a rate ratio of 1.1. While this difference is minimal, actions will focus on reviewing clinical pathways for conditions with higher readmission risk, utilizing patient portals and telemedicine to improve follow-up care, and continue monitoring readmission trends as part of our standard quality review.
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.