Opportunities of the healthcare sector in Colombia.
A veces cambiar There el is fondo a good de business & social color climate ayuda (security, business trends, governance) Especialmente Haga cuando clic para necesita modificar hacer el énfasis estilo en de algo título o cambiar del patrón de tema
Safety 120 100 103 80 60 40 20 0 55 48,3 34 29,2 24 21,8 20,4 18,2 16 12 6 Homicides per 100.000 inhabitants in 2007 Three of the main Colombian cities are safer than Washington D.C. Source: Crime Observatories
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 Exports in 2012 (US$ millones) Growth (2011-2012) Mexico 370.826.831 6,2% Colombia 59.024.246 3,6% Argentina 80.927.108-3,6% Chile 78.276.984-3,8% Peru 45.228.600-3,9% Brazil 242.579.776-5,3% Source: Trademap
Foreign Direct Investment (FDI), Exports, and Tourism Us millon dolars 60.000 Exports 40.000 20.000 0 Exports increased 214% between 02/08; so far 2011 increase in 70% Us millon dolars 15.000 10.000 5.000 Foreign Direct Investment (FDI) FDI increased 397% between 02/08; so far for 2011 increased in 64% 2000 1500 1000 500 0 0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Tourism 2002 2003 2004 2005 2006 2007 2008 2009 2010 The number of visitors increased 120% between 02/08; so far this year have increased 19%
Colombia is second in Latin America and 27th in the World Environmental Performance Index (2012) World Ranking Country Mexico Peru Chile Argentina Brazil Colomia 49,11 50,29 55,34 56,48 60,9 62,33 0 10 20 30 40 50 60 70 Rating 5 Costa Rica 27 Colombia 30 Brasil 31 Ecuador 50 Argentina 56 Venezuela 58 Chile 81 Perú 84 Mexico Source: Environmental Performance Index 2012, Yale University http://epi.yale.edu/dataexplorer/tableofmainresults
Media is starting to highlight Colombia's Improvement
A veces Stucture cambiar of Colombia s el fondo de Healthcare color ayuda sector Especialmente Haga cuando clic para necesita modificar hacer el énfasis estilo en de algo título o cambiar del patrón de tema
Structure of the Healthcare System in Colombia Law 100 of 1993 Contributory System Contributions by workers and employers EPS Health Management Companies POS Obligatory Health Plan Subsidized System For those who are unable to pay SISBEN Identification and Classification System for Potential Beneficiaries of Social Programs 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. 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. Fuente: Secretaria Distrital de Salud de Bogotá D.C.
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 22 nd 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. Colombia allocates 7.5% of its GDP, and 13.9 % of its public expenditure in healthcare 1 -France 2- Italy 21 - Belgium 22 - Colombia 23 - Sweden 25 - Germany 30 - Canada 33 - Chile 36 - Costa Rica 37 - United States 39 - Cuba 47 - Thailand 61 - Mexico 75 - Argentina 125 -Brazil 0,573 0,755 0,722 0,838 0,834 0,807 0,881 0,870 0,849 0,915 0,910 0,908 0,902 0,000 0,200 0,400 0,600 0,800 1,000 0,994 0,991
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. % 20 15 10 5 0-5 -10-15 -20-25 Variation (%) of Annual Health Service Demand in Latin America (2006-2010) 2006 2007 2008 2009 2010 2011* 2012* Chile Colombia México Perú Venezuela Group with the greatest regional growth Fuente: Organización Mundial de la Salud EIU
Source: World Bank. Elaboration:Proexport Health expenditure in colombia 90 80 70 60 50 40 Health expenditure, public sector (% of total health expenditure) (2002 2011) 74,8 56,1 49,4 47,6 45,7 41 México Perú Ecuador Brasil Chile Colombia 30 20 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Source: World Bank. Elaboración: Proexport Health expenditure 10 Health expenditure (% of total GDP) (2002 2011) 9 8 7 6 5 4 8,9 7,5 7,3 6,2 6,1 4,8 México Perú Ecuador Brasil Chile Colombia 3 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Expectativa de Vida (Años) 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) 76 74 72 70 68 66 Health Leveling Spending Health coverage at 88% and Life Expectancy at 74.6 Balanced Spending 12 10 8 6 4 2 Gasto en la Salud (% PIB) 64 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 0 Expectativa de Vida Gasto en Salud % PIB Source: Organización Mundial de la Salud EIU
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 el fondo de Medical tourism color ayuda around the world and in Colombia Especialmente Haga cuando clic para necesita modificar hacer el énfasis estilo en de algo título o cambiar del patrón de tema
Medical tourism in response to Canada Long wait times Europe Aging population Income decrease United States High costs Uninsured population Caribbean Technology availability Low capacity Japan Aging population Hospitalization times Quality Africa Low capacity Quality problems Accesibility Technology Wait times Fuente: ANDI Elaboración: Proexport
Top 20 destinations for medical tourism Estimated market value of US$15 billion Top 20 destinations by number of patients Approx. 5 million patients worldwide Average spending per surgery is US$3,000 Fuente: Patients without borders (Medical Tourism Facts). ANDI Elaboración: Proexport
Global market (2008 2014) Market value (2008-2014) Wellness Esthetic medicine Preventive medicine Preventive medicine Income in US$ billion PROYECTIONS 2014 Curative medicine - 300,000 travelers - US$4,000 million Preventive and esthetic medicine - 1,200,000 travelers - US$2,600 million Wellness - 58,000,000 travelers - US$48,000 million Fuente: ANDI
Medical tourism expenditure by region Regional medical tourism expenditure In 2010, 3,5% of total tourism expenditure was in medical tourism. Colombia has high quality reputation in medical tourism, specially among Latin-Americans. Fuente: Euromonitor
Outbound patient flow for medical tourism is estimated have a growth rate over 10 times 25 20 15 10 5 U.S. Outbound Patient Flow Projection (Million) (2007 2017) 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Base Case Lower Bound Upper Bound U.S. Medical Travel trend shows the tremendous potential for international arrivals seeking medical treatments in Colombia Source: Deloitte LLC
US$ million Colombian Medical Tourism Exports Colombian medical tourism exports (2007 - June 2013) 140,0 120,0 134,0 115,6 100,0 80,0 60,0 40,0 42,8 59,8% 68,5-39,4% 41,5 27,8% 50,7% 53,0 77,0 75,2% 46,0 151,2% 20,0 0,0 2007 2008 2009 2010 2011 2012 Ene - Jun 2012 Ene - Jun 2013 Source: Productive Transformation Program (PTP)
US$ million Non-resident patients Non-resident patients* (2011 - Junio 2013) 29.170 30.000 24.477 25.000 20.000 63,8% 17.805 145,1% 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.
ene-11 feb-11 mar-11 abr-11 may-11 jun-11 jul-11 ago-11 sep-11 oct-11 nov-11 dic-11 ene-12 feb-12 mar-12 abr-12 may-12 jun-12 jul-12 ago-12 sep-12 oct-12 nov-12 dic-12 ene-13 feb-13 mar-13 abr-13 may-13 jun-13 Percentage (%) Trend of non-resident patients 4,0% 3,5% Monthly share of non-resident guests that declared health purposes among total travelers (2011 - Junio 2013) 3,0% 2,5% 2,0% 1,5% 1,0% 0,5% 0,0% Source: DANE. Monthly hospitality survey- Non-resident guests that declared health purposes.
Country of Origin of international patients 700 600 500 Country of origin of international patients for medical travel to Colombia (2011 Jun 13) 2013 Curazao Aruba 25,0% 5,9% 6,2% 7,8% 27,5% 13,8% 13,8% Curazao Aruba Holanda Venezuela Estados Unidos Ecuador Otros 400 Holanda 300 200 Venezuela Estados Unidos Ecuador 100 - Ene - Jun 11 Jul - Dic 11 Ene - Jun 12 Jul - Dic 12 Ene - Jun 13 Source: Migración Colombia, MinCIT
A veces Added cambiar value el fondo of the de Colombian color ayuda offer Especialmente Haga cuando clic para necesita modificar hacer el énfasis estilo en de algo título o cambiar del patrón de tema
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. INFRASTRUCTURE Ensuring adequate infrastructure is in place to suit industry needs. ACTION PLAN 184 Initiatives
Competitive Analysis Medical Tourism Index (MTI) Exporting strategy includes the following key strategies Cost Cost comparison Opportunities Country image Travelers to Colombia International patients Medical Tourism Index (MTI) Quality Hospital recognition Accreditations Human Talent Quality and availability Infrastructure Hospitals Capacity Accessibility Source: McKinsey PTP Elaboration: Proexport
Medical Tourism Index Standard and score 5,4 6,0 1 Cost: 30% 10,0 1,0 1,6 2,0 4,0 3,8 2 Quality: 15% 1,5 3,7 5,8 7,3 Medical Tourism Index 1 = Most atractive 10 = Lest atractive 3 4 Infrastructure: 15% Human Resources 20% 1,0 1,0 10,0 3,4 7,2 6,3 9,9 9,9 Strength Source: ANDI Elaboration: Proexport 5 Country Image: 20% 2,2 3,8 5,0 6,9 Weakness
Recognition of Colombian hospitals in Latin America 2013 Rank 45 Top hospitals in Latin America (Colombia) 2013 2012 Rank Hospital City Total No. Doctors* 2013 No. of beds 2013 4 7 Fundación Valle del Lili Cali 309 473 6 8 Fundación Cardio infantil Bogotá 233 325 Fundación Cardiovascular de 8 9 Colombia Bucaramanga 116 207 10 18 Hospital Pablo Tobón Uribe Medellín 248 371 19 Colombian hospitals in the ranking of the top 45 hospitals in LatAm (3 more than in 2012) 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 Bogotá has 8 of these hospitals, Medellin has 7, Cali and Bucaramanga have 2 each 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 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. 38 - Clínica Reina Sofía Colsánitas Bogotá 96 133 40 36 Clínica Marly Bogotá 74 108
Accreditations México Cost: 25%-35% of the US High volume of tourists from the US Dental and cosmetic surgery 9 accreditations with JCI Saudi Arabia 32 accreditations with JCI United Arab Emirates 45 accreditations with JCI Turkey 41 accreditations with JCI Singapore Cost: 50%-60% of the US Focus on regional market 17 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 Brazil Cost: 50%-60% of the US Cosmetic surgery 23 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 Quality
Accreditations Voluntary process of internal and external inspection, that allows continuous delivery of safe healthcare services with high 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. Quality
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. 159 San Juan de Pasto Nariño Clínica los Nogales S.A.S. 191 Bogotá Cundinamarca Hospital San Vicente de Paul 304 Rionegro Antioquia Sociedad Clínica Cardiovascular Corazón Joven S.A. 175 Neiva Huila Fundación FOSUNAB 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 202 Pereira Risaralda Centro Hospitalario Serena del Mar S.A. 75 Cartagena Bolívar TOTAL 1.757 Infrastructure
Strategic Location Los Angeles 8H20M México México D.F 4H45M United States Quito 1H30M Infrastructure Canada Ecuador Lima 3H00M Peru Santiago Chile 5H00M Miami 3H00M Chile Toronto 6H05M New York 5H35M Caracas 1H20M Brazil Sao Paulo 5H45M Buenos Aires 6H15M Argentina Madrid 9H40M París 10H40M Spain France Frankfurt 11H15M Germany 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 20.000 Undergrad in Health sciences, Medicine and Nursing school in Colombia (2001 2011) 15.861 16.307 16.279 15.000 13.109 14.381 14.313 16.272 17.183 12.967 14.212 13.422 10.000 5.000 3.626 3.779 4.376 4.296 4.314 4.178 4.661 4.689 4.809 5.698 5.228 0 1.854 1.934 2.460 2.675 2.392 2.389 2.976 3.164 2.909 3.173 3.051 Medicina Enfermería Total graduados Ciencias Salud Fuente: Observatorio Laboral para la educación. Elaboración Proexport. Human Talent
Educational Opportunities in the Sector Grad School 5000 4500 4000 3500 3000 2500 2000 1500 1000 2.147 2.076 1.120 1.065 Grad school in Health sciences, Medicine and Nursing school in Colombia (2001 2011) 2.341 1.184 2.404 1.012 2.720 2.808 2.727 1.165 999 3.141 1.065 1.165 3.433 1.350 3.792 1.482 4.243 1.840 500 0 396 128 221 73 154 131 194 239 198 176 77 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Medicina Enfermería Total graduados Ciencia de la Salud Human Talent Fuente: Observatorio Laboral para la educación. Últimos datos posgrado Elaboración Proexport.
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.