Cardinal Glennon Footprints: Chart Review Cost Data Collection Form
This form is used for determining costs of care and/or service utilization.
Evaluation Tools - Cost/Utilization
SSM Cardinal Glennon Children's Hospital
1465 South Grand Boulevard
St. Louis, MO 63104
Mary Ann Collins, MHA
How the grantee used this instrument:
The form was used in collecting data from 1998 records of all inpatient visits of children who have died.
pediatrics, costs of care form, cost analysis, utilization data
To use this tool:
You may print and copy this tool for your own use from this site. Please credit source.
Developed specifically for this project by the project team. Copyright © 2001 Footprints at SSM Cardinal Glennon Children's Hospital. All Right Reserved.
To view this tool:
To view the tool in your browser left-click on the link below or to download to your computer right-click on the link.
PDF 112 KB / 4 pages
Posted June 30, 2003
SSM Cardinal Glennon Children's Hospital overview page
# GLEN10, type:cost/utilization
Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit PromotingExcellence.org for more resources.