1. Trends in Healthcare Challenges and opportunities
Seminário: Inovação na Saúde Brasil - Holanda
Oportunidades para cooperação entre São Paulo e Amsterdam

3. Anahp | Representativeness

4. The health market in the world | Brazil is a key player
7th Largest Healthcare Market in the World
3rd Largest Healthcare Market for private healthcare in the World
Total healthcare expenditures (2013) in Billion US dollars
Private healthcare expenditures (2013) in Billion US dollars
United States
China
Brazil
Germany
United States
China
Japan
China
Germany
Japan
France
France
Russia
Canada
United Kingdom
Brazil
Canada
Italy
India
Others
Others
Fonte: Elaboração Anahp com base em dados da Organização Mundial da Saúde

5. Despite losses with the recession, the private system is larger than the national systems of many countries
Insured population (millions)
Source: ANS Data

6. Most of the expenses in health are from the private sector
Health Expenditures
2015 (Estimates)
Total health expenditures
9,5% of GDP
R$563,1 B
Private (55%)
Public (45%)
5,2% of GDP
R$308,3 B
4,3% of GDP
R$254,8 B
State
(1,2% of GDP)
R$72,5 B
Private Insurance (2,4% of GDP)
R$143,9 B
Out-of-pocket (2,8% of GDP)
R$164,5 B
Federal
(1,5% of GDP)
R$91,7 B
Municipal
(1,5% of GDP)
R$90,6 B
Source: Data from Secretaria do Tesouro Nacional, IBGE and ANS | Estimate for 2015

7. Room for growth | fewer hospital beds per person than other countries
Average number of hospital beds (per 1000 inhabitants)
Netherlands 4,7
Fonte: OECD and WHO data
(E) Estimate

8. Trends | Transitions Ageing Population
Changes in the clinical and epidemiological profile
Operational Management
Long-term care
Hospital Quality

9. Ageing | End of the demographic bonus by 2030, with an acceleration of the population ageing process
Demographic pyramid (2015, and estimates for 2020 and 2030)

10. Changes in the clinical and epidemiological profile | Growth of Noncommunicable Chronic Diseases due to demographic, economic, cultural and environmental factors
Percentage of the population affected by selected chronic diseases – by age (Brazil, 2013)
Arterial Hypertension
Diabetes
Elevated Cholesterol

11. Management | Trend of growing investments in IT, in search of more accurate cost control, higher quality of care and better outcomes for patients
Greater use of management tools (eg.: DRGs)
Enhances control of resource availability, severity of cases, associated costs and pricing, allowing a better management of clinical teams, processes and results
Measurement of outcomes
Allows constant improvement of clinical and management practices, in search of better patient safety and higher quality of care
More robust governance systems
Professional management of the business and of the clinical staff (integrative governance)
More widespread compliance systems

12. Long-term care | Reduction in the rate of long-term patients in hospitals indicate better de-hospitalization practices
Rehabilitation
Treatment
Healthy
Citizen
Diagnosis
Long term patients (>90 days) as % of hospital releases
Prevention
Primary
Care
Hospital
Care
Home
Care

13. Quality | Rising number of accreditations indicates growing concern with inputs, processes and results
Accreditations

14. Challenges to international cooperation
“Brazil is not for beginners”*, but there are no insurmountable
obstacles. The main barriers are:
Commercial and Regulatory
There is protection of the internal Market. Standards set by regulatory agencies often impose difficulties on innovation.
Cultural
Health professions in Brazil are well-establish and may resist the adoption of new models developed abroad
Human Resources
There are few professionals in the market capable of managing transnational health projects at a high level
Institutional
Not many health institutions are ready for an international relationship
*Quote by Tom Jobim, Brazilian composer

15. Some of the opportunities for international cooperation
Investment in a market with strong perspectives for growth
Law nº13.097/2015 authorized foreign investment in healthcare. There are significant investment opportunities in healthcare infrastructure and technology, and in Public-private partnerships
Management
Brazil has much to learn from international experiences and models of excellence in management, and needs to develop good managers in greater numbers
Technology, Research and Development
Brazil has particular challenges in healthcare that require greater investment in developing solutions for local issues

16. Thank you!
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