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Patient Demographic Form

    The word demography means the study of statistics. It is the analysis of the number of births, deaths, incidence, and prevalence of different diseases within a community over a specific period. It also studies the changes occurring in the human population.

    Demography is a vast subject that includes the study of the size, structural build-up, and distribution of human populations. It measures the changes in these statistics, whether in time or space, over a determined period. These changes include births, deaths, and migrations.

    Demographic Data

    Data can be collected and analyzed using various rates and ratios, some of which are described below:

    • Crude birth rate: number of live births per thousand people in a year
    • Crude death rate: number of deaths per thousand people in a year
    • The expectation of life is the number of years an individual is expected to live at a certain age, according to current mortality rates
    • Infant mortality rate: number of deaths of children less than 1 year of age per thousand live births in a year
    • Total fertility rate: the number of live births per woman completing her reproductive life according to current age-specific fertility rates

    Demographic Cycle

    The demographic cycle, also known as the population cycle, is the evolution of a specific population over time.

    Stages of Demography

    Stage 1: Pre-transition/high stationery: high birth rates and high death rates.

    Stage 2: Early transition/early expansion: The death rate begins to fall, the birth rate remains high, and the population starts to grow rapidly. Examples: Afghanistan and Palestine.

    Stage 3: Late transition/late expansion: decrease in birth rate and deceleration of population growth. Examples: India and the United Arab Emirates.

    Stage 4: Post-Transition/Low Stationery: With low birth and death rates, population growth is minimal. Examples: Japan and Denmark.

    Stage 5: Declining: The birth rate is lower than the death rate, hence the population growth is declining. Examples: Sweden and Norway.

    Importance of Demography

    Demography helps to identify the issues and causes related to morbidity and mortality in the population. Moreover, it aids in categorizing the demands of growth and the aging of the population.

    Characteristics of Demography

    Various factors can be described statistically, like age, sex, level of education, income, marital status, religion, occupation, employment, rate of births, rate of deaths, rate of reproduction, and the average size of a family.

    Patient Demographic Form

    The patient demographic form consists of:

    • Patient information: Full name, father’s name, age, sex, date of birth, occupation, race, religion, street address, phone number, ethnicity, marital status, email address, and language
    • Date and time of filling out the form
    • Emergency contact; name, age, contact number, address, and relationship to patient
    • Source of finance: name, occupation, address, and contact number
    • Information about a referral: name of the physician, address, and contact number
    • Insurance information: insurance company, patient’s relationship to the insured person, social security number, sex, and date of birth
    • Agreement to privacy and confidentiality
    • Name and signature of consenter/patient
    Patient Demographic Form
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