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This document provides instructions and data fields required for the October 2011 Quarterly Patient Origin Survey, including necessary discharge data for July, August, and September. It details the
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How to fill out OCTOBER 2011 QUARTERLY PATIENT ORIGIN SURVEY

01
Start by gathering the necessary patient information from your records.
02
Ensure that you have the correct survey form for the October 2011 Quarterly Patient Origin Survey.
03
Fill out the patient demographics section including age, gender, and address.
04
Record the type of services provided during the survey period.
05
Document the primary reason for the patient's visit.
06
Include data on how patients arrived at your facility (transportation methods).
07
Review the completed survey for accuracy and completeness.
08
Submit the completed survey to the appropriate department or agency by the deadline.

Who needs OCTOBER 2011 QUARTERLY PATIENT ORIGIN SURVEY?

01
Healthcare providers and facilities participating in the patient origin survey.
02
State health departments requiring data for planning and evaluation.
03
Researchers studying healthcare access and patient demographics.
04
Policy makers needing information to inform healthcare policies.
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The OCTOBER 2011 QUARTERLY PATIENT ORIGIN SURVEY is a data collection process conducted by healthcare organizations to determine the geographic origins of patients admitted or treated within a specific timeframe, allowing for the analysis of patient demographics and movement.
Healthcare facilities such as hospitals, clinics, and other medical providers that receive patients are typically required to file the OCTOBER 2011 QUARTERLY PATIENT ORIGIN SURVEY.
To fill out the OCTOBER 2011 QUARTERLY PATIENT ORIGIN SURVEY, facilities must gather data on the patients' residential addresses, categorize them into geographic regions, and input the collected data into the designated reporting format as guided by the instructions provided with the survey.
The purpose of the OCTOBER 2011 QUARTERLY PATIENT ORIGIN SURVEY is to understand patient demographics, track healthcare service usage trends, and aid in resource allocation and planning within healthcare systems.
Facilities must report information such as the number of patients from various geographic areas, demographic details (age, gender), and the services provided to track patient movement and treatment across regions.
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