Alameda Health System

ALAMEDA HEALTH SYSTEM

Reporting Organization
ALAMEDA HEALTH SYSTEM
Report Period
01/01/2024 – 12/31/2024
Hospital / Hospital System
Hospital System
Report Type
General Acute Care Hospital

Hospitals

Hospital Count: 3

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 CO
Race and/or Ethnicity Black or African American 27.2% Hispanic or Latino 19.0% 2.90
2. HCAI 30-Day readmission NOBH
Race and/or Ethnicity Native Hawaiian or Pacific Islander 26.2% Hispanic or Latino 9.5% 2.80
3. HCAI 30-Day readmission
Preferred Language English Language 17.7% Middle Eastern Languages 6.6% 2.70
4. HCAI 30-Day readmission
Expected Payor Medicare 18.8% Other 7.3% 2.60
5. HCAI 30-Day readmission NOBH
Expected Payor Medicare 17.2% Private 7.1% 2.40
6. HCAI 30-Day readmission CO
Race and/or Ethnicity White 22.3% Hispanic or Latino 19.0% 2.40
7. CMQCC NTSV cesarean rate
Expected Payor Medicaid 0.2% Other 0.2% 2.30
8. HCAI 30-Day readmission MHD
Age (excluding maternal measures) 50 to 64 22.9% 18 to 34 10.3% 2.20
9. HCAI 30-Day readmission CO
Expected Payor Medicaid 24.5% Medicare 22.6% 2.20
10. HCAI 30-Day readmission NOBH
Age (excluding maternal measures) 65 and older 16.6% 18 to 34 7.7% 2.20

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2. Equity Plan

In recognition of our aging population, particularly within Alameda Hospital, AHS started in June 2024 the SNF Collaborative. The goal is to strengthen the relationship between community SNF partners and our AHS facilities to address readmission disparities, promote palliative care, initiate advanced care planning, and ensure patient preferences are honored. Palliative care resources at Alameda Hospital will expand to outpatient in early 2026 providing additional opportunities to collaborate with our SNF partners. In addition to our resources, we have made available to our Medicare patients ONclick Healthcare, which is a transitional care resource that ensures their needs are being met post-discharge. From the convenience of home, and through an assigned care counselor, patients will have access to care continuity, coordinated care with physicians, prescription management, patient education, symptoms management, access to community resources, and transportation to appointments.

We see a greater prevalence of readmissions in our Black or African American, White, Native Hawaiian or Pacific Islander, and Asian groups. While this correlates with readmission rates, we do not believe this is a causal factor but rather reflects differences in underlying clinical and social factors. Many patients in our population experience multiple comorbidities—such as diabetes, heart failure, renal failure, and polysubstance use—that contribute to readmission risk. To reduce avoidable readmissions, we are focused on strengthening post-hospitalization care coordination and improving connections to complex care teams. These services and resources are available to all AHS patients, with support tailored to each patient's medical and social needs. We are strengthening our partnership with Alameda Alliance and the Community Health Center Network (CHCN) to bolster care coordination for patients who receive follow up care external to AHS. Additionally, our case managers have access to the Readmission Assessment tool in Epic to identify patients who may benefit from enhanced case management or community health advocate resources. Lastly, to address readmissions among the unhoused population, AHS contracted with Cardea Health. Cardea operates a medically supported shelter in Alameda that opened in May 2023. This program serves patients who would benefit from a safe environment for recuperation and continued access to medical and social support services.

3. Web Address for Equity Report

https://www.alamedahealthsystem.org/

4. Download Equity Measures Report

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

Hospital Equity Measures Report Download

Click on the link below to download all equity measures reports.