Diapositiva 1

Opportunities of the healthcare sector
in Colombia.
A veces cambiar
el is
fondo
de
There
a good
colorclimate
ayuda
business & social
(security, business trends, governance)
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Safety
120
100
103
80
60
55
48,3
34
40
20
29,2
24
21,8
20,4
18,2
16
12
0
Homicides per 100.000 inhabitants in 2007
Three of the main Colombian cities are safer than Washington D.C.
Source: Crime Observatories
6
Colombia: A dynamic economy
GDP Growth Rate
Data: World Bank. Source: World Development Indicators. Google Public Data.
Note: Last updated September 6, 2012
Trade indicators
Of all the Latin American countries, Colombia´s economy
was the least affected by the 2009 crisis.
Exports (2012)
Source: Ministerio de Hacienda y Crédito Publico
Mexico
Colombia
Argentina
Chile
Peru
Brazil
Exports in 2012
Growth
(US$ millones) (2011-2012)
370.826.831
6,2%
59.024.246
3,6%
80.927.108
-3,6%
78.276.984
-3,8%
45.228.600
-3,9%
242.579.776
-5,3%
Source: Trademap
Foreign Direct Investment (FDI),
Exports, and Tourism
Us millon dolars
Exports
60.000
Exports increased 214%
between 02/08; so far
2011 increase in 70%
40.000
20.000
0
Us millon dolars
Foreign Direct Investment (FDI)
15.000
FDI increased 397%
between 02/08; so far for
2011 increased in 64%
10.000
5.000
0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
The number of visitors
increased 120% between
02/08; so far this year have
increased 19%
Tourism
2000
1500
1000
500
0
2002
2003
2004
2005
2006
2007
2008
2009
2010
Colombia is second in Latin America
and 27th in the World
Environmental Performance Index (2012)
Mexico
49,11
Peru
50,29
Chile
55,34
Argentina
56,48
Brazil
60,9
Colomia
62,33
0
10
20
30
40
Rating
Source: Environmental Performance Index 2012, Yale University
http://epi.yale.edu/dataexplorer/tableofmainresults
50
60
70
World
Ranking
Country
5
Costa Rica
27
Colombia
30
Brasil
31
Ecuador
50
Argentina
56
Venezuela
58
Chile
81
Perú
84
Mexico
Media is starting to highlight Colombia's
Improvement…
Stucture
of Colombia´s
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Structure of the Healthcare System in
Colombia
Law 100 of 1993
Contributory System
Subsidized System
Contributions by workers
and employers
For those who are unable
to pay
POS
Obligatory
Health Plan
EPS
SISBEN
Identification and
Classification System for
Potential Beneficiaries of
Social Programs
Health Management
Companies
IPS
Healthcare Providers
Level I, II and III Hospitals, Clinics and Laboratories
Healthcare providers (IPS)
by Level of Care
FIRST LEVEL OF
CARE
Promotion and prevention
activities, basic care plan
activities, general medical
exams, clinical laboratory,
radiology, hospitalization,
emergency care and labor
and deliveries with a Low
Level of Complexity.
SECOND LEVEL OF
CARE
Medical exams,
hospitalization, basic
emergency care
specialties (surgery,
pediatrics) and certain
sub-specialties such as
laboratory work, dentistry
and psychology with a
Medium Level of
Complexity.
Fuente: Secretaria Distrital de Salud de Bogotá D.C.
THIRD LEVEL OF CARE
This level is associated with
all health plan services
involving specialties
(cardiology, plastic surgery)
and sub-specialties with a
High Level of Complexity as
well as critical care for adults,
children and newborns.
Health Regulatory Entities
The Ministry is responsible for coordinating,
executing and overseeing public
governmental policies related to health.
The Superintendence is responsible for
monitoring, controlling and overseeing all
actions and activities of the General Health
Social Security System.
Sector Associations
Law 1438 of 2011: Toward an equal,
sustainable, quality healthcare system
Provisions of the law address:
Instruments for improving health quality.
Instruments for ensuring better operation.
An improved service delivery network.
Public health, prevention, promotion and primary care.
Instruments for ensuring better medication market operation.
Additional financing resources.
Better resource flow.
Inspection, oversight and control.
Human resources.
Healthcare system – World Health
Organization.
• Colombia ranks 22nd in the
world, being the best
healthcare system in Latin
America.
• World Health Organization
ranks Colombian healthcare
system as one of the best
among developing countries.
1 -France
0,994
2- Italy
0,991
21 - Belgium
0,915
22 - Colombia
0,910
23 - Sweden
0,908
25 - Germany
0,902
30 - Canada
0,881
33 - Chile
0,870
36 - Costa Rica
0,849
37 - United States
0,838
39 - Cuba
0,834
47 - Thailand
0,807
61 - Mexico
• Colombia allocates 7.5% of its
GDP, and 13.9 % of its public
expenditure in healthcare
0,755
75 - Argentina
0,722
125 -Brazil
0,000
0,573
0,200
0,400
0,600
0,800
1,000
Colombia has some of the greatest demands for
health services in Latin America
In the last decade, Colombia's variation in health service demand has remained positive, with
one of the best growth perspectives for upcoming years.
%
Variation (%) of Annual Health Service Demand in
Latin America (2006-2010)
20
Group with the greatest
regional growth
15
10
5
0
-5
2006
2007
2008
2009
2010
2011*
-10
-15
-20
-25
Chile
Fuente: Organización Mundial de la Salud – EIU
Colombia
México
Perú
Venezuela
2012*
Health expenditure in colombia
Health expenditure, public sector (% of total health expenditure)
(2002 – 2011)
90
80
74,8
70
México
Perú
Ecuador
60
56,1
Brasil
50
49,4
47,6
45,7
Chile
40
41
30
20
2002
2003
2004
Source: World Bank. Elaboration:Proexport
2005
2006
2007
2008
2009
2010
2011
Colombia
Health expenditure
Health expenditure (% of total GDP)
(2002 – 2011)
10
9
8,9
8
7,5
7,3
7
6
5
2004
Source: World Bank. Elaboración: Proexport
2005
2006
2007
2008
2009
2010
Ecuador
Brasil
4,8
Colombia
3
2003
Perú
6,2
6,1
4
2002
México
2011
Chile
Health expenditure
Since Law 100 of 1993 came into effect, health spending has increased significantly to make
up for existing needs. As a result, Colombian life expectancy has grown steadily.
Life Expectancy vs. Health Spending (% GDP)
Expectativa de Vida (Años)
12
74
10
Health
Leveling
Spending
72
8
70
6
Balanced Spending
68
4
66
2
64
0
1993
1995
1997
1999
2001
Expectativa de Vida
Source: Organización Mundial de la Salud – EIU
2003
2005
2007
2009
Gasto en Salud % PIB
2011
Gasto en la Salud (% PIB)
Health coverage at 88%
and Life Expectancy at
74.6
76
Healthcare services in Colombia
Colombia is experiencing a historic period of growth
and development. Years of innovation and top quality
medical care have strengthened the health sector
here.
Colombia is an attractive investment destination that
offers a benefits package especially designed to
improve business opportunities through tax and
operational incentives.
Colombia is a great opportunity thanks to our
successes over the years, the experiences of those
who already know us, and the benefits we offer for
investment.
Colombia has a History of Innovation
Colombia has a histoy of innovation and accomplishments that led to an
international recognition of the country and its practitioners.
Some of the accomplishments are:
Válvula de Hakim. 1964
Dr. Salomón Hakim
Marcapasos. 1963
Dr. Jorge Reynolds Pombo
Vacuna contra la Malaria. 1986
Dr. Manuel Patarroyo.
A veces cambiar
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de
Medical
tourism
around the world and in
Colombia
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Medical tourism in response to…
Europe
Canada
• Long wait times
• Aging population
• Income decrease
United States
• High costs
• Uninsured population
Japan
Caribbean
• Aging population
• Hospitalization times
• Technology availability
• Low capacity
Africa
• Low capacity
• Quality problems
Quality
Accesibility
Technology
Wait times
Fuente: ANDI
Elaboración: Proexport
Top 20 destinations for medical tourism
Top 20 destinations
by number of patients
Estimated market value of
US$15 billion
Approx. 5 million patients
worldwide
Average spending per
surgery is US$3,000
Fuente: Patients without borders (Medical Tourism Facts). ANDI
Elaboración: Proexport
Global market (2008 – 2014)
Market value (2008 - 2014)
PROYECTIONS 2014
Curative medicine
Wellness
-
Preventive and esthetic
medicine
Esthetic medicine
Preventive medicine
Preventive medicine
300,000 travelers
US$4,000 million
-
1,200,000 travelers
US$2,600 million
Wellness
Income in US$ billion
Fuente: ANDI
-
58,000,000 travelers
US$48,000 million
Medical tourism expenditure by region
Regional medical tourism expenditure
In 2010, 3,5% of total
tourism expenditure was in
medical tourism.
Colombia has high quality
reputation in medical
tourism, specially among
Latin-Americans.
Fuente: Euromonitor
Outbound patient flow for medical tourism is
estimated have a growth rate over 10 times
U.S. Outbound Patient Flow
Projection (Million)
(2007 – 2017)
25
20
15
10
5
0
2007
2008
2009
2010
Base Case
2011
2012
Lower Bound
2013
2014
2015
2016
Upper Bound
U.S. Medical Travel trend shows the tremendous potential for
international arrivals seeking medical treatments in Colombia
Source: Deloitte LLC
2017
Colombian Medical Tourism Exports
Colombian medical tourism exports
(2007 - June 2013)
134,0
140,0
115,6
US$ million
120,0
100,0
77,0 75,2%
68,5
50,7%
80,0
-39,4%
42,8
60,0
151,2%
53,0
46,0
41,5
59,8%
27,8%
40,0
20,0
0,0
2007
2008
2009
Source: Productive Transformation Program (PTP)
2010
2011
2012
Ene - Jun 2012
Ene - Jun 2013
Non-resident patients
Non-resident patients*
(2011 - Junio 2013)
29.170
30.000
24.477
US$ million
25.000
63,8%
17.805
20.000
145,1%
15.000
9.987
10.000
5.000
-
2011
2012
Ene-Jun 2012
Ene-Junio 2013
*Information of total non-resident travelers from Migración Colombia
Source: DANE. Monthly hospitality survey- Non-resident guests that declared “health” purposes.
Trend of non-resident patients
Monthly share of non-resident guests that declared
“health” purposes among total travelers
(2011 - Junio 2013)
4,0%
3,5%
Percentage (%)
3,0%
2,5%
2,0%
1,5%
1,0%
0,5%
Source: DANE. Monthly hospitality survey- Non-resident guests that declared “health” purposes.
jun-13
may-13
abr-13
mar-13
feb-13
ene-13
dic-12
nov-12
oct-12
sep-12
ago-12
jul-12
jun-12
may-12
abr-12
mar-12
feb-12
ene-12
dic-11
nov-11
oct-11
sep-11
ago-11
jul-11
jun-11
may-11
abr-11
mar-11
feb-11
ene-11
0,0%
Country of Origin of international patients
2013
27,5%
700
Country of origin of international patients for
medical travel to Colombia
(2011 – Jun 13)
Curazao
Aruba
25,0%
13,8%
Holanda
Venezuela
5,9%
6,2%
13,8%
7,8%
Estados Unidos
Ecuador
Otros
600
Curazao
500
Aruba
400
Holanda
Venezuela
300
Estados Unidos
200
Ecuador
100
Ene - Jun 11
Jul - Dic 11
Source: Migración Colombia, MinCIT
Ene - Jun 12
Jul - Dic 12
Ene - Jun 13
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Experience
Fertility and Reproductive Procedures
Oncology
Cardiology
Bariatric Surgery
Ophthalmologic Surgeries
Aesthetic Dental Work
Plastic and Reconstructive Surgeries
Comprehensive Medical Exams
Stem Cells Studies and Procedures
The Productive Transformation Program
A public-private strategy aimed to strengthen world-class sectors. The program intends to
develop and execute business plans to boost economic growth and generate skilled jobs. The
strategy encompasses both established and emerging sectors.
Stimulating the development of
ESTABLISHED SECTORS
into world class
performers
Promote the development of
world class performers of NEW
AND EMERGING
sectors
Colombian Patient Safety Policy
Relates directly with the
global trend on quality in
healthcare
Progress of SUA(Mandatory
System to Guarantee Patient
Safety and Care) which
relies on the results achieved
with the patient
Patient Safety
Policy
The professionalism in our
service providers
Patient safety first.
At the Forefront of International Medicine
High-Tech Medicine with a Human Touch
• Doctors and nurses are highly qualified, they have been trained in the best
universities and medical centers in the world.
• Colombia has invested in building modern hospitals and clinics equipped with the
latest technology.
• Colombia has one of the most modern and developed healthcare systems in South
America.
Easily Accessible
• Colombia’s national air carrier, Avianca, connects with 22 international destinations
• Delta, American, Continental and several US airlines offer more than 29 daily nonstop flights between the U.S. and Colombian main cities.
• Colombia is 3 hours away from Miami, and less than 6 hours from New York and
Washington by plane.
Personalized Attention at an Affordable Cost
• Most Colombian hospitals assist foreign patients with travel and lodging
accommodations and provide guidance and translation services as needed.
• In Colombia, medical procedures cost between 10% and 35% less compared to the
USA costs
• Our medical institutions have the infrastructure and technological resources to rank
among the finest health centers in the world with JCI accreditation
Business plans include initiatives along
four key strategies.
HUMAN RESOURCE DEVELOPMENT
Pertinence, improved skills, readiness and retention in the
buscar
industry. Bilingualism and promotion of universityindustry partnerships.
LEGAL AFFAIRS & REGULATION
Adapt the regulatory framework to suit the
industry’s needs.
INDUSTRY AFFAIRS
Put in place strategies to: attract foreign
investment , strengthen the sector
representation, boost management capabilities
.
ACTION PLAN
INFRASTRUCTURE
Ensuring adequate infrastructure is in
place to suit industry needs.
184
Initiatives
Competitive Analysis
Medical Tourism Index (MTI)
Exporting strategy includes
the following key strategies
Cost
• Cost comparison
• Opportunities
Country
image
Quality
• Travelers to
Colombia
• International
patients
Medical
Tourism
Index
(MTI)
Human
Talent
• Quality and
availability
• Hospital recognition
• Accreditations
Infrastructure
• Hospitals
• Capacity
• Accessibility
Source: McKinsey – PTP
Elaboration: Proexport
Medical Tourism Index
Standard and score
1
5,4
4,0
Cost: 30%
10,0
1,0
1,6
3,8
Medical Tourism
Index
1 = Most atractive
10 = Lest atractive
Source: ANDI
Elaboration: Proexport
2,0
6,0
2
Quality: 15%
3
Infrastructure: 15%
4
Human Resources 20%
5
Country Image: 20%
1,5
3,7
10,0
5,8
7,3
7,2
6,3
9,9
9,9
1,0
1,0
2,2
3,4
Strength
3,8
5,0
6,9
Weakness
Recognition of Colombian hospitals in
Latin America
45 Top hospitals in Latin America (Colombia) – 2013
2013
Rank
2012
Rank
Total No.
Doctors* 2013
No. of beds
2013
4
7
Fundación Valle del Lili
Cali
309
473
6
8
Bogotá
233
325
9
Fundación Cardio infantil
Fundación Cardiovascular de
Colombia
8
Bucaramanga
116
207
10
18
Hospital Pablo Tobón Uribe
Medellín
248
371
14
20
Centro Médico Imbanaco
Cali
334
121
19
26
Clínica las Américas
Medellín
69
322
20
19
Hospital San Ignacio de Bogotá
Bogotá
245
314
23
24
San Vicente de Paul Medellín
Medellín
279
656
25
-
Clínica Shaio
Bogotá
181
274
26
30
Foscal
Bucaramanga
304
294
27
29
Inst de Ortopedia Infantil Roosevelt
Bogotá
23
118
29
44
Mederi
Bogotá
494
782
30
31
Hospital General de Medellín
Medellín
72
418
32
34
Clínica León XIII
Medellín
275
641
34
35
Clínica del Occidente
Bogotá
176
181
35
38
Clínica Medellín
Medellín
33
187
38
-
Clínica Reina Sofía Colsánitas
Bogotá
96
133
40
36
Clínica Marly
Bogotá
74
108
Hospital
City
19 Colombian hospitals in
the ranking of the top 45
hospitals in LatAm (3
more than in 2012)
Bogotá has 8 of these
hospitals, Medellin has 7,
Cali and Bucaramanga
have 2 each
Source: América Economía Intelligence.
* Full-time doctors
** La Fundación Santa Fe de Bogotá decidió no
participar en el ranking 2013.
*** La Clínica Universitaria Bolivariana de
(Medellín) entró en el puesto 42 al ranking 2013.
Accreditations
México
• Cost: 25%-35% of the US
• High volume of tourists from the US
• Dental and cosmetic surgery
• 9 accreditations with JCI
United Arab Emirates
• 45 accreditations with JCI
Saudi Arabia
• 32 accreditations with JCI
Turkey
• 41 accreditations with JCI
Costa Rica
• Cost: 30%-40% of the US
• Dental and cosmetic surgery
• 3 accreditations with JCI
Colombia
• Cost: 25%-40% of the US
• 3 accreditations with JCI
• 9 free trade zones
Quality
Brazil
• Cost: 50%-60% of the US
• Cosmetic surgery
• 23 accreditations with JCI
Singapore
• Cost: 50%-60% of the US
• Focus on regional market
• 17 accreditations with JCI
India
• Cost: 15%-20% of the US
• Qualified doctors studied in the US
• High technology
• 16 accreditations with JCI
Thailand
• Cost: 30%-40% of the US
• Elective procedures
• Attractive touristic destination
• 12 accreditations with JCI
Malaysia
• Cost: 30%-40% of the US
• Plastic surgery and
alternative medicine
• 6 accreditations with JCI
Accreditations
Voluntary process of internal and external
inspection, that allows continuous delivery of
safe healthcare services with high quality.
Quality
Organization that certifies a
healthy environment for their
patients, visitors and staff.
Moreover, it has to assure the
continuous improvement of
customer service processes.
Free Trade Zones
There are 11 Free Trade Zones for the healthcare sector in Colombia.
COMPANY / HOSPITAL
EMPLOYMENT
LOCATION
Clínica Portoazul S.A.
150
Puerto Colombia - Atlántico
Clínica Hispanoamerica S.A.S.
Clínica los Nogales S.A.S.
Hospital San Vicente de Paul
159
191
304
San Juan de Pasto –Nariño
Bogotá – Cundinamarca
Rionegro – Antioquia
175
Neiva –Huila
198
Floridablanca – Santander
Fundación Cardiovascular de Colombia S.A.S
167
Pedecuesta – Santander
Medical Duarte ZF S.A.S.
86
Cúcuta - Norte de Santarder
Fresenius Medical Care Servicio Renal S.A.S.
50
Cúcuta - Norte de Santarder
Clínica Megacentro Pinares
Centro Hospitalario Serena del Mar S.A.
202
75
Pereira – Risaralda
Cartagena – Bolívar
TOTAL
1.757
Sociedad Clínica Cardiovascular Corazón
Joven S.A.
Fundación FOSUNAB
Infrastructure
Strategic Location
Frankfurt
11H15M
París
10H40M
United States
Los Angeles
8H20M
New York
5H35M
México D.F
4H45M
Madrid
9H40M
Caracas
1H20M
Ecuador
Quito
1H30M
Lima
3H00M
Santiago Chile
5H00M
Infrastructure
Brazil
Peru
Chile
France
Spain
Miami
3H00M
México
Germany
Toronto
6H05M
Canada
Sao Paulo
5H45M
Buenos Aires
6H15M
Argentina
Connectivity:
• More than 700 direct-flight
frequencies.
• Avianca-Taca: One of the main
airlines in Latin America.
• Easy access to main cities in Latin
America.
• More than 26 airlines travel to
Colombia
• GMT -5 hours
Educational Opportunities in the Sector
Undergraduate
Undergrad in Health sciences, Medicine and Nursing
school in Colombia
(2001 – 2011)
20.000
16.307
15.861
15.000
14.381
17.183
14.313
16.272
13.109
14.212
12.967
16.279
13.422
10.000
5.698
5.000
3.626
1.854
0
3.779
1.934
4.376
2.460
Medicina
4.296
2.675
4.314
2.392
Enfermería
4.178
2.389
4.689
4.809
2.976
3.164
2.909
Total graduados Ciencias Salud
Fuente: Observatorio Laboral para la educación. Elaboración Proexport.
Human Talent
4.661
3.173
5.228
3.051
Educational Opportunities in the Sector
Grad School
Grad school in Health sciences, Medicine and Nursing
school in Colombia
(2001 – 2011)
5000
4500
4.243
3.792
4000
3.433
3500
3.141
2.720
3000
2500
2.341
2.808
2.727
2.404
2.076
2.147
1.840
2000
1500
1.120
1.065
1.184
1.012
1.165
1.350
1.065
999
1.482
1.165
1000
500
73
77
128
221
154
131
198
2004
2005
2006
396
194
239
176
0
2001
2002
Medicina
Human Talent
2003
Enfermería
2007
2008
2009
2010
Total graduados Ciencia de la Salud
Fuente: Observatorio Laboral para la educación. Últimos datos posgrado
Elaboración Proexport.
2011
Famous International Clients
“Australian singer Kylie Minogue received a teeth
whitening treatment in Colombia from dentist Dr.
Christian Salazar”
Source: El Tiempo newspaper
"Renowned Puerto Rican sexologist Alexandra
Rampolla underwent bariatric surgery in Colombia with
excellent results."
Source: www.eltiempo.com
Former Argentine soccer player Diego Armando
Maradona underwent gastric bypass surgery in
Colombia to reduce his weight."
Source: BBC Mundo.
Country´s Image
Colombia has international insurance agreements
that bring foreign patients to the country for
high-quality procedures at lower costs.
Proexport facilitates your business with
Colombia
Proexport has representatives
nationwide to provide you with
relevant information about the
medical tourism industry .
Our specialists can help you to get in
contact with healthcare providers in
Colombia, giving more information
and access to our clinics.