SEQUOIA 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
|
Expected Payor | Medicare | 11.5% | Private | 4.7% | 4.90 |
|
2.
HCAI 30-Day readmission
|
Expected Payor | Medicaid | 7.3% | Private | 4.7% | 3.10 |
|
3.
HCAI 30-Day readmission
|
Age (excluding maternal measures) | 65 and older | 10.9% | 50 to 64 | 7.1% | 1.50 |
|
4.
HCAI 30-Day readmission NOBH
|
Sex Assigned at Birth | Male | 11.0% | Female | 7.1% | 1.50 |
|
5.
HCAI 30-Day readmission
|
Race and/or Ethnicity | White | 9.4% | Asian | 6.3% | 1.50 |
|
6.
HCAI 30-Day readmission
|
Race and/or Ethnicity | Hispanic or Latino | 7.4% | Asian | 6.3% | 1.20 |
2. Equity Plan
Sequoia Hospital analyzed the year end 2024 health data for potential health equity disparities in the population we serve. The analysis revealed that Sequoia Hospital's 30-day readmission data for 2023-2024 reveals several key disparities. The top 6 identified disparities are in these four categories:
Age: Higher rates in age groups 65+ compared to the 50-64 year old reference group.
Insurance: Higher rates in Medicare and Medicaid populations compared to the privately insured reference group.
Sex: Higher rates in the male population compared to the female reference population.
Race/Ethnicity: Higher rates in White and Latino populations compared to the Asian reference group.
Sequoia Medicare patients exhibit the highest readmission rates, followed by Medicaid patients. Readmissions are also significantly higher in the age 65 and older group, among male patients, and within the White race/ethnicity group. For most of these identified disparities (Medicare, Medicaid, age 65+, male, and White ethnicity), readmission rates have shown a positive trend, decreasing since 2023 to their lowest in 2024 due to ongoing performance improvement efforts. However, the Hispanic/Latino race/ethnicity group stands out as the second-highest race/ethnicity for readmissions and has experienced a slight increase in overall readmissions since 2023, prompting the identification of specific initiatives to address this particular disparity.
Sequoia Hospital: 2025 Strategy for Adult All-Cause Readmission Reduction: In 2025, Sequoia Hospital aims to significantly reduce adult all-cause readmission rates to at or below 2.5% by the close of CY 2025 improving upon our CY 2024 baseline. This strategic initiative integrates ongoing efforts from Care Coordination and collaborating departments, supported by a newly established readmission workgroup.
Our approach includes:
Data-Driven Analysis:
-Thorough case review and stratification by age, sex, payor, race/ethnicity, and critical diagnoses such as Sepsis and Heart Failure to pinpoint key drivers.
Proactive Risk Mitigation:
-Implementing an electronic application for early identification of readmission risks during admission and pre-discharge.
-Conducting post-discharge follow-up calls by hospital healthcare workers to address social determinants of health and facilitate subsequent appointments.
-Providing targeted education on readmission risks to Home Health services, particularly for high-risk populations like Heart Failure patients and Sepsis patients.
Comprehensive Patient Support:
-Ensuring communication in the patient's preferred language from admission through discharge.
-Facilitating timely primary care follow-up.
-Verifying complete understanding of discharge medications and instructions for at-risk patients.
-Appropriate treatment in the Emergency Department (ie Unconscious Bias Training, equipping them to provide more empathetic, unbiased, and safe care)
-Appropriate treatment for any identified trauma related needs when admitted
-Providing appropriate transportation services where identified
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.