Rady Children's Hospital Orange County
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
|
Race/Ethnicity | Hispanic or Latino | 14.8% | Asian | 8.5% | 1.70 |
|
2.
HCAI 30-Day readmission
|
Race/Ethnicity | White | 14.1% | Asian | 8.5% | 1.70 |
|
3.
HCAI 30-Day readmission
|
Age | 10–14 years | 17.5% | 5–9 years | 12.5% | 1.40 |
|
4.
HCAI 30-Day readmission
|
Expected Payor | Medicaid | 14.9% | Private | 11.8% | 1.30 |
|
5.
HCAI 30-Day readmission
|
Preferred Language | Spanish Language | 15.4% | English Language | 13.5% | 1.10 |
|
6.
HCAI 30-Day readmission
|
Age | 15 years and older | 14.2% | 5–9 years | 12.5% | 1.10 |
|
7.
Pediatric survey recommend hospital
|
Race/Ethnicity | Black or African American | 80.8% | White | 87.3% | 1.10 |
|
8.
Pediatric survey recommend hospital
|
Preferred Language | English Language | 85.7% | Spanish Language | 92.1% | 1.10 |
|
9.
Pediatric survey recommend hospital
|
Expected Payor | Private | 84.2% | Medicaid | 90.0% | 1.10 |
|
10.
HCAI 30-Day readmission
|
Sex Assigned at Birth | Female | 14.5% | Male | 13.6% | 1.10 |
2. Equity Plan
Overview and Findings
A system-level analysis of Children’s Hospital of Orange County (CHOC), now part of Rady Children’s Health, reveals notable disparities in the AB 1204 equity measures for Calendar Year 2024 by race/ethnicity, payor type, age, sex assigned at birth, and preferred language. Across hospitals, readmission rates were higher among Hispanic patients, White patients, patients insured through Medicaid, and Spanish-speaking patients. Notably, these same groups also reported higher willingness to recommend the hospital.
Key Disparities & Insights
All-Cause Unplanned 30-Day Hospital Readmission Rate
- Race/Ethnicity: Asian patients showed the lowest readmission rate at 8.5% compared to Hispanic or Latino patients at 14.8% and White patients at 14.1%, both reflecting a rate ratio (RR) of 1.7.
- Age: Patients aged 5-9 years showed the lowest readmission rates at 12.5% compared to those aged 10-14 years at 17.5% (RR of 1.4) and 15 years and older at 14.2% (RR of 1.1).
- Payor: Patients with private insurance showed a lower readmission rate of 11.8%, compared to patients insured through Medicaid at 14.9% (RR 1.3).
- Language: Patients preferring English had a lower readmission rate of 13.5% compared to those preferring Spanish at 15.4% (RR 1.1).
- Sex Assigned at Birth: Male patients had a slightly l ower readmission rate of 13.6% compared to female patients at 14.5% (RR 1.1).
Pediatric Experience Survey with Scores of Willingness to Recommend the Hospital
- 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% (RR 1.1).
- Language: Families of patients preferring Spanish reported the highest willingness-to-recommend rate at 92.1% compared to families of patients preferring English at 85.7% (RR 1.1).
- Payor: Families of patients with Medicaid insurance showed the highest willingness-to-recommend rate with a rate of 90.0%, compared to families of patients with private insurance at 84.2% (RR 1.1).
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
3. Web Address for Equity Report
4. 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.