Hsr 2 Form
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II. HOSPITAL OPERATIONS 1.
Summary of Patients in the Hospital 1.1 Patients remaining in the hospital as of midnight last day of previous month/year. 1.2 Total Admissions (excluding Newborn) 1.3 Total Discharges (Alive) 1.4 Total In- patients Deaths 1.5 Total Patients Admitted and Discharged the same day 1.6 Total In-patients Service Days for the Period *
__________ __________ Newborn _______ __________ __________ __________ __________
1.7 Average Daily Census of Admitted Patients
____________
Total in-patient service days fro the period* Total days in period
1.8 Referrals (In-patient) 1.8.1 1.8.2 1.8.3 2.
Type of service
from RHU from other hospitals/centers to other health facilities
______________ ______________ ______________
DISCHARGES 2.1 Services rendered and patients attended
No. Of Pts.
Total length of stay/ total No. of Days Stay
CONDITION ON CHARGES PhilHealth
Non-PhilHealth
Service Pay
Service Charity
Total
Pay
TOTAL DISHG
DEATHS
Member / Depdnt
Total
O H W M R/I W O A
T
H
A
Died U <48 hrs
Died =>48 hrs
Total
Indig
Medicine Obstetrics Gynecology Pediatrics Surgery Pedia Adult Others Specify TOTAL
TOTAL Newborn: -Pathologic -Non-Patho
* R/I- Recovered/Improved T- Transferred H- Home against Medical AdviceA- Absconded
U-Unimproved D-Died (died upon admission)
2.2 Average Length of Stay (ALOS) of Admitted Patients Total Length of stay of discharged patients (incl.Deaths) in the period Total discharges and deaths in the period
_________
Summary of Patients in the Hospital 1.1 Patients remaining in the hospital as of midnight last day of previous month/year. 1.2 Total Admissions (excluding Newborn) 1.3 Total Discharges (Alive) 1.4 Total In- patients Deaths 1.5 Total Patients Admitted and Discharged the same day 1.6 Total In-patients Service Days for the Period *
__________ __________ Newborn _______ __________ __________ __________ __________
1.7 Average Daily Census of Admitted Patients
____________
Total in-patient service days fro the period* Total days in period
1.8 Referrals (In-patient) 1.8.1 1.8.2 1.8.3 2.
Type of service
from RHU from other hospitals/centers to other health facilities
______________ ______________ ______________
DISCHARGES 2.1 Services rendered and patients attended
No. Of Pts.
Total length of stay/ total No. of Days Stay
CONDITION ON CHARGES PhilHealth
Non-PhilHealth
Service Pay
Service Charity
Total
Pay
TOTAL DISHG
DEATHS
Member / Depdnt
Total
O H W M R/I W O A
T
H
A
Died U <48 hrs
Died =>48 hrs
Total
Indig
Medicine Obstetrics Gynecology Pediatrics Surgery Pedia Adult Others Specify TOTAL
TOTAL Newborn: -Pathologic -Non-Patho
* R/I- Recovered/Improved T- Transferred H- Home against Medical AdviceA- Absconded
U-Unimproved D-Died (died upon admission)
2.2 Average Length of Stay (ALOS) of Admitted Patients Total Length of stay of discharged patients (incl.Deaths) in the period Total discharges and deaths in the period
_________
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