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) __________ 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 * __________

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 from RHU ______________
1.8.2 from other hospitals/centers ______________
1.8.3 to other health facilities ______________

2. DISCHARGES
2.1 Services rendered and patients attended

Total
length CONDITION ON CHARGES
of stay/
total PhilHealth DEATHS TOTAL
Non-PhilHealth DISHG
Type No. No. of
of Of Days O Died Died Total
H
service Pts. Stay Service Total W
M R/I T H A U <48 =>48
Service W hrs hrs
Pay Total Pay O
Charity Member A
/ Indig
Depdnt
Medicine

Obstetrics

Gynecology

Pediatrics
Surgery
Pedia
Adult
Others
Specify

TOTAL

TOTAL

Newborn:
-Pathologic

-Non-Patho

* R/I- Recovered/Improved T- Transferred U-Unimproved

H- Home against Medical AdviceA- Absconded 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