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Hospital Profile
• NOTE: This is not an audit. The research team will ensure that any identifying information
obtained through this survey will remain strictly confidential and will not be used for any other
purposes other than this research.
• The survey is self-administered and can be considered a form of self-assessment for the
hospitals, which may also help provide insight about their current level of achievement in
relation to the IPSGs. Therefore, it is highly recommended for the respondents to provide the
most accurate information that corresponds to the actual situation in the hospital at the time
of the survey using any available reference or knowledge from a qualified resource person/s.
• Before returning the survey, please check all the pages to ensure that all items have been
answered/ completed. Do not leave any item blank.
RESPONDENT INFORMATION
HOSPITAL PROFILE
Indicators Questionnaire
Hospital Profile
Please describe your hospital by providing your answers to each item in the “ANSWER” column using
the corresponding items in the “ANSWER FORMAT/ OPTIONS” column as a guide.
HP-8 Referring hospital/s (please list all List all applicable LHC, Private/Public Hospital
applicable)
HP-9 PHIC Reimbursement Amount for 2016 Indicate number 94,836,240 ( Accounting Section )
HP-12 Other Accreditation/s, please specify List all applicable Philhealth, ISO
Indicators Questionnaire
Hospital Profile
Indicators Questionnaire
Hospital Profile