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Department of Health
HEALTH FACILITIES AND SERVICES REGULATORY BUREAU
ANNEX - E
A.O. No. 2012-0012
ANNUAL HEALTH FACILITY STATISTICAL REPORT
YEAR 2017
I. GENERAL INFORMATION
A. Classification
1. Service Capability
Service capability: Capability of a hospital/other health facility to render administrative, clinical, ancillary
and other services
General:
[ ✔ ] Level 1 Hospital Specialty: (Specify)
[ ] Level 2 Hospital [ ] Treats a particular
[ ] Level 3 Hospital (Teaching/Training) disease
[ ] Treats a particular
[ ] Infirmary organ
[ ] Treats a particular
Trauma Capability: class of patients
[ ✔ ] Trauma Capable [ ] Others(Specify):
[ ] Trauma Receiving
2. Nature of Ownership
Government: Private:
[ ] National - DOH Retained/Renationalized [ ✔ ] Single
[ ] Local (Specify): Proprietorship/Partnership
[ ] Province /Corporation
[ ] City [ ] Religious
[ ] Municipality [ ] Civic Organization
[ ] Foundation
[ ] DILG - PNP [ ] Others(Specify):
[ ] DND - AFP
[ ] DOJ
[ ] State Universities and Colleges (SUCs)
[ ] Others (Specify):
B. Quality Management
Quality Management/Quality Assurance Program: Organized set of activities designed to demonstrate on-
going assessment of important aspects of patient care and services
[ ] ISO Certified (Specify ISO Certifying Body and area(s) of the hospital with
Validity Period:
Certification)
Validity Period:
[ ✔ ] PhilHealth Accreditation
[ ✔ ] Basic Participation Jan 01, 2017 -
[ ] Advanced Participation Dec 31, 2017
C. Bed Capacity/Occupancy
o Bed Occupancy Rate: The percentage of inpatient beds occupied over a given period of time. It is a
measure of the intensity of hospital resources utilized by in-patients.(given period of time is January 1 to
December 31each year for the annual statistics)
o Inpatient Service days (Inpatient bed days): Unit of measure denoting the services received by one in-
patient in one 24 hour period.
o Total Inpatient Service days or Inpatient Bed days =[(Inpatients remaining at midnight + Total
admissions) - Total discharges/deaths) + (number of admissions and discharges on the same day)].
For each category listed below, please report the total volume of services or procedures performed.
**Inpatient: A patient who stays in a health facility licensed to admit patients, while under treatment
Total number of inpatients transferred FROM THIS FACILITY to another facility for
63
inpatient care
Total number of patients remaining in the hospital as of midnight last day of previous
30
year
B. Discharges
28 2,53 2,75 3
Medicine 2,819 7,955 0 284 0 2,535 0 2 0 0 0 22 9 31 2,819
4 5 8 0
Gynecology 50 112 8 0 8 0 42 42 0 0 50 0 0 0 0 0 0 0 50
24 2,58 2,78 2
Pediatrics 2,821 8,593 0 240 0 2,581 0 19 0 0 0 10 3 13 2,821
0 1 2 6
Surgery
Pedia 10 21 0 0 0 0 10 10 0 0 10 0 0 0 0 0 0 0 10
Adult 92 92 8 0 8 0 84 84 0 0 92 0 0 0 0 0 0 0 92
Other(s)
Total
583 1,319 40 0 40 0 543 543 0 0 578 2 0 0 0 3 0 3 583
Newborn
Pathologic 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Non-
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pathologic
Total length of stay of discharged patients (including Deaths) in the period = 2 - 3 Day(s)
Total Discharges and Deaths for the same period
Average length of stay: Average number of days each inpatient stays in the hospital for each episode of
care.
2. Ten Leading causes of Morbidity based on final discharge diagnosis
For each category listed below, please report the total number of cases for the top 10 illnesses/injury.
7. Tuberculosis 79 A15-A19
3.
Kindly accomplish the "Ten Leading Causes of Morbidity/Diseases Disaggregated as to Age and Sex" in the table below.
1.
Influenza 1 1 4 4 9
4 3 4 5 2 2 1 2 1 1 2 2 1 1 1 2 1 2 1 1 2 1 2 2 2 2 4 4 J10-
and 0 0 9 9 5 5 1
6 2 8 5 8 8 6 4 1 1 0 1 1 4 1 1 2 3 4 6 2 4 4 3 4 7 2 7 J18
pneumoni 3 4 9 1 0
a
2. Chronic
3 3 6
lower 1 1 4 3 4 3 2 2 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 2 3 4 J40-
1 4 5
respirator 6 3 0 9 6 3 5 7 9 9 2 4 2 7 2 1 1 8 2 3 6 4 4 7 6 5 6 0 7 1 3 0 J47
7 1 8
y diseases
3.
2 2 5 A00
Intestinal 1 1 6 4 2 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1
9 9 7 8 9 8 7 6 -
infectious 3 2 6 6 0 8 4 9 5 9 8 8 6 9 7 2 2 3 9 9 8 3 3 4 1 5 4
9 6 5 A09
diseases
4. Other
diseases 1 3 4 N30
1 2 3 4 2 2 2 4 2 1 1 1 2 1 1 1 1 1 2
of the 3 7 6 8 9 6 7 7 5 7 5 6 6 7 0 8 -
8 4 8 4 0 8 3 3 0 2 5 9 0 2 0 0 2 2 1
urinary 7 6 3 N39
system
5.
Diseases
of 2 2 4 K20
1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3
esophagus 5 7 8 2 5 7 -
4 6 6 3 5 0 0 6 4 5 4 1 8 7 6 7 6 2 6 3 3 9 5 4 4 5 5 9 2
, stomach 0 5 5 K31
and
duodenum
6.
1 2
Hypertens 1 2 1 1 2 1 2 1 2 1 4 9 I10-
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 4 6 8 8 9 7 7
ive 6 3 2 2 1 8 3 7 3 7 5 3 I15
7 0
diseases
7. A15
1 4 3 7
Tuberculo 0 0 0 0 0 0 1 1 2 1 2 1 2 2 1 1 2 2 3 5 4 3 2 1 5 3 7 2 6 4 6 -
0 7 2 9
sis A19
8. Other
diseases
1 4 3 7 J30-
of upper 0 1 7 6 5 7 3 2 3 1 1 2 3 2 2 2 2 1 2 1 2 1 2 1 1 1 1 0 1 2 2
1 0 8 8 J39
respirator
y tract
Deliveries Number
ICD-10
Ten Leading OPD Consultations Number
Code
4. Symptoms and signs involving the digestive system and abdomen 519 R10-R19
6. Symptoms and signs involving the circulatory and respiratory systems 181 R00-R09
6.
7. Ten Leading Causes of ER Consultation
ICD-10
Ten Leading ER Consultations Number
Code
4. Symptoms and signs involving the digestive system and abdomen 169 R10-R19
6. Symptoms and signs involving the circulatory and respiratory systems 63 R00-R09
8.
9. TESTING
Total number of medical imaging tests (all types including x-rays, ultrasound, CT
Number
scans, etc.)
X-Ray 2,788
Ultrasound 0
CT-Scan 0
MRI 0
Mammography 0
Angiography 0
Linear Accelerator 0
Dental X-Ray 0
Other 0
Total number of laboratory and diagnostic tests (all types, excluding medical
imaging)
Urinalysis 4,081
Fecalysis 1,232
Hematology 7,529
Immunology/Serology/HIV 0
Surgical Pathology 0
Autopsy 0
Cytology 0
11.
C. Deaths
For each category of death listed below, please report the total number of deaths.
Total deaths 56
Gross Death Rate = Total Deaths (including newborn for a given period) x 100
Total Discharges and Deaths for the same period
2.
Net Death Rate = Total Deaths (including newborn for a given period) - death < 48 hours for the period x 100
Total Discharges (including deaths and newborn) - death < 48 hours for the period
4.
1.
Ischemi I20-
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 3 3 5 7 12
c heart I25
diseases
2.
Influen
J10-
za and 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 4 3 7 10
J18
pneumo
nia
3.
Chronic
lower J40-
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 3 1 5 1 6
respirat J47
ory
diseases
4.
Infectio
ns
P35-
specific 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 2 4
P39
to the
perinata
l period
5.
Cerebro
I60-
vascula 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 1 3 1 4
I69
r
diseases
6.
Metabo
E70-
lic 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2
E90
disorder
s
7. Other
forms I30-
0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 2
of heart I52
disease
8. Other
bacteria A30-
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 2 2
l A49
diseases
D. Healthcare Associated Infections (HAI)
HAI are infections that patients acquire as a result of healthcare interventions. For purposes of Licensing, the four
(4) major HAI would suffice.
For All Hospitals (General and Specialty)
3. Urinary Tract Infection (UTI) = Number of Patients (with catheter) with UTI x 1000
Total Number of Catheter Days
Surgical Site Infections (SSI) = Number of Surgical Site Infections(Clean Cases) x 100
Total number of Clean Procedures done
Percentage (%)
INFECTION RATE 0.00
Device Related Infections
Ventilator Acquired Pneumonia (VAP) 0.00
Blood Stream Infection (BSI) 0.00
Urinary Tract Infection (UTI) 0.00
Non-Device Related Infections
Surgical Site Infections (SSI) 0.00
E. Surgical Operations
1. Major Operation refers to surgical procedures requiring anesthesia/ spinal anesthesia to be performed in an
operating theatre. ( Refer to different cutting specialties.)
2. Minor Operation refers to surgical procedures requiring only local anesthesia/ no OR needed, example suturing.
(Refer to different cutting specialties)
3.
4.
A. Medical
1. Consultants 0 0 0 0 0 0 0 0
a. Generalist 0 1 0 0 0 4 5
b. Cardiologist 0 0 0 0 0 0 0
c. Endocrinologist 0 0 0 0 0 0 0
d. Gastro-
0 0 0 0 0 0 0
Enterologist
e. Pulmonologist 0 0 0 0 0 0 0
f. Nephrologist 0 0 0 0 0 0 0
g. Neurologist 0 0 0 0 0 0 0
1.2. Obstetrics/
Gynecology (and sub- 0 0 1 0 0 0 0 1
specialty)
1.3. Pediatrics (and
0 0 0 0 0 1 1
sub-specialty)
1.5. Anesthesiologist 0 0 0 0 0 0 0
1.6. Radiologist 0 1 0 0 0 1 0 2
1.7. Pathologist 0 0 1 0 0 0 0 1
2. Post-Graduate Fellows
(Indicate 0 0 0 0 0 0 0 0
specialty/subspecialty)
3. Residents 0 0 0 0 0 0 0 0
3.2. Obstetricts-
0 0 0 0
Gynecology
3.3. Pediatrics 0 0 0 0
3.4. Surgery 0 0 0 0
SUB-TOTAL: 0 2 2 0 0 7 0 11
B. Allied Medical
1. Nurses 0 21 11 0 0 0 0 32
2. Midwives 1 0 1
3. Nursing Aides 1 0 1
4. Nutritionist 1 0 1
5. Physical Therapist 0 0 0
6. Pharmacists 2 0 2
7. Medical Technologist 0 0 0
8. Laboratory Technician 3 0 3
9. X-Ray Technologist/X-
2 0 2
Ray Technician
SUB-TOTAL: 0 34 11 0 0 0 0 45
C. Non-Medical
1. Chief Administrative
0 1 0 0 0 0 0 1
Officer
2. Accountant 1 0 1
3. Budget officer 0 0 0
4. Cashier 1 0 1
5. Clerk 6 0 6
6. Engineer 0 1 1
7. Driver 1 0 1
- Janitorial 14 0 0 0 0 0 14
- Maintenance 1 0 0 0 0 0 1
- Security 0 2 0 0 0 0 2
SUB-TOTAL: 0 40 3 0 0 0 0 43
GRAND TOTAL: 0 76 16 0 0 7 0 99
IV. EXPENSES
Amount in
Expenses
Pesos
Amount spent on personnel salaries and wages 4,080,000.00
Amount spent on benefits for employees (benefits are in addition to wages/salaries.
588,000.00
Benefits include for example: social security contributions, health insurance)
Allowances provided to employees at this facility (Allowances are in addition to
wages/salaries. Allowances include for example: clothing allowance, PERA, vehicle 60,000.00
maintenance allowance and hazard pay.)
TOTAL amount spent on all personnel including wages, salaries, benefits and
4,728,000.00
allowances for last year (PS)
Total amount spent on medicines 0.00
Total amount spent on medical supplies (i.e. syringe, gauze, etc.; exclude
2,000,000.00
pharmaceuticals)
Total amount spent on utilities 100,000.00
Total amount spent on non-medical services (For example: security, food service,
1,500,000.00
laundry, waste management)
TOTAL amount spent on maintenance and other operating expenditures
3,600,000.00
(MOOE)
Amount spent on infrastructure (i.e., new hospital wing, installation of ramps) 5,000,000.00
Amount spent on equipment (i.e. x-ray machine, CT scan) 1,500,000.00
TOTAL amount spent on capital outlay (CO) 6,500,000.00
GRAND TOTAL 14,828,000.00
V. REVENUES
Please report the total revenue this facility collected last year. This includes all monetary resources acquired by this
facility from all sources including donations.
Amount in
Revenues
Pesos
Total amount of money received from the Department of Health 0.00
Total amount of money received from the local government 0.00
Total amount of money received from donor agencies (for example JICA, USAID, and
0.00
others)
Total amount of money received from private organizations (donations from
0.00
businesses, NGOs, etc.)
Total amount of money received from Phil Health 24,000,000.00
Total amount of money received from direct patient/out-of-pocket charges/fees 300,000.00
Total amount of money received from reimbursement from private insurance/HMOs 0.00
Total amount of money received from other sources (PAGCOR, PCSO, etc.) 0.00
GRAND TOTAL 24,300,000.00
Designation/Section/Department: / / Date: