1. 1st BDMS-OHSU ACS SYMPOSIUM. Feb 7, 2019
BDMS CoE Heart
Pradub Sukhum MD, FACC

2. Presentation outline
Thailand healthcare system
Thailand healthcare coverage
BDMS history of expansion
BDMS hub and spoke model – network
Birth of BDMS CoE, BDMS Heart CoE
Affiliation program, Domestic and International

3. THAILAND HEALTHCARE

5. Thailand Healthcare Coverage
Healthcare Segments in Thailand
Total Expenditure for 2014: THB 360 bn
THB 41 bn
THB 114 bn
THB 60 bn
THB 145 bn
Source: SSO, NHSO, WHO, BOT, Phatra Securities estimates
Universal Healthcare Coverage (UHC)
A welfare program for Thai people to receive medical coverage for IPD and OPD care at registered facilities for payment of Baht 30 (US$ 1.00) per visit
Civil Servant (CS)
A welfare program provided to employees of governments and state-owned enterprises
Social Security Scheme (SS)
Minimum requirement of healthcare provided to employees of private companies
Private Healthcare (Cash)
Proportion of Thai population not covered or choose not to use public healthcare schemes (UHC, CS and SS), though may have private insurance coverage

6. BDMS MEDICAL HUB ROAD MAP

7. BDMS Market Share in Thailand6 1 2 3 4 7 8 5 12 9 10 11
PNwm
PChok
PMed
PYT2
PYT1
PYT3
BNH
SVH
SNH
BHQ
BPD
5 km
Region
Total Private Hospital Beds
BDMS Registered Beds
Market Share
Bangkok
14,339
2,571
18%
Central
10,654
1,890
17%
South
2,467
601
24%
Northeast
2,904
337
12%
North
4,128
194 5%
Total
34,492
5,593
16%
BCT
STH
5 km
PSamut
Source: Department of Health Service Support as of Sep 2014

8. BDMS Networking Development
1972 – 2004 – 2011 – 2016 – 2018 …………..
1. Complete Quantitative Networking
2015
Muang Petch
Sri-Rayong
Dibuk
Samitivej Chonburi
Muangraj 18
2013
Samitivej Thonburi
Bangkok Phitsanulok 31 29
2011
Bangkok Hua Hin
Bangkok Pakchong
Health Network (8 Phyathai & Paolo hospitals)
2012
Bangkok Udon 28
2007
Royal Angkor International (Cambodia)
Royal Rattanak (Cambodia) * 16
2006
Increase in stake of Bangkok Pattaya, Bangkok Chanthaburi and Samitivej Sriracha (became subsidiaries)
Bangkok Ratchasima
2005
BNH
Wattanosoth 10
2004
Bangkok Heart
Bangkok Samui
Bangkok Phuket
Samitivej Sukhumvit and Samitivej Srinakarin 12 37
2014
Bangkok Chiangmai
Royal Phnom Penh (Cambodia)
Bangkok Chinatown
Bangkok Khon Kaen
Sanamchan and Thepakorn
Phuket International 42
Share Price (THB)
2016
Paolo Rangsit 43
# Number of hospitals in the network post-acquisition
Green font indicates Greenfield projects Brown font indicates acquisitions
2. Initiating Qualitative Networking

9. BDMS Hub-and-Spoke Groups BDMS Hup and Spokes Groups
1. Bangkok Hospital % 343
2. Bangkok Heart Hospital (BHQ) %
Wattanosoth Hospital %
Bangkok Huahin (BHN) %
Bangkok Chinatown (BCT) %
Sanamchan (BSN) % 200
Thepakorn (TPK) % 100
Muang Petch (MPH) %
Muangraj 100% 125
Ownership No. of Beds (1)
Group 4
Bangkok Khon Kaen (BKN) %
Bangkok Phrapradaeng (BPD) % 60
Royal Phnom Penh (RPH) %
Royal Angkor International (RAH) % 30
Ownership No. of Beds (1)
Group 5
Phyathai 1 (PYT1) 100% 350
Phyathai 2 (PYT2) 99.2% 260
Phyathai 3 (PYT3) % 240
Phyathai Sriracha (PYTS) 74.4% 350
Phyathai Nawamin (Pnwm) 99.8% 140
Paolo Paholyothin (Pmed) 100% 300
Paolo Samutprakarn(Psamut) % 200
Paolo Chokchai 4 (Pchok) 85.7% 148
Paolo Rangsit 100% 150
Group 2
Samitivej Sukhumvit (SVH) % 275
Samitivej Srinakarin (SNH) % 400
Samitivej Sriracha (SSH) % 150
Samitivej Thonburi (STH) %
Samitivej Chonburi (SCH) % 220
BNH Hospital (BNH) % 144
Group 6
Bangkok Phuket (BPK) % 266
Phuket International (PIH) % (2)
Dibuk (DBK) % 100
Bangkok Hat Yai (BHH) % 200
Bangkok Samui (BSH) %
Group 3
Bangkok Pattaya (BPH) % 400
Bangkok Rayong (BRH) % 220
Bangkok Chanthaburi (BCH) % 170
Bangkok Trat (BTH) % 114
Sri Rayong (SRH) %
Check
Group 7: Non-Hospital
National Healthcare System %
Bio Molecular Laboratories %
The Medicpharma %
A.N.B Laboratories %
Save Drug Center %
General Hospital Products %
Group 4
Bangkok Chiangmai (BCM) %
Bangkok Ratchasima (BKH) % 180
Bangkok Pakchong % 31
Bangkok Udon (BUD) % 120
Bangkok Phitsanulok (BPL) % 195
Structured beds
Having the capability to accommodate an expansion to become 281 beds
Remarks 10

11. ‘Hub-and-Spoke‘ Model
Effective hub and spoke model within each hospital group or region 1
Strong patient referral system within and across each hub and spoke
Clinics / Medical Diagnostics
Spoke
Referral
patients
Doctors 2
Enhances synergies and benefits of scale among hospitals within the group
Hub (Super Tertiary / Tertiary)
Referral
patients
Patients 3
Shared supporting services among multiple hubs which enhance efficiency and competitiveness of BDMS
Nurses
Referral
patients
Spoke
Medical equipment
Spoke
Referral
patients 4
Established system provides a platform for future expansion

12. ‘Hub-and-Spoke‘ Model
BDMS Centers of Excellence Network
Bangkok Hospital Chiangmai
Bangkok Hospital Udon
Bangkok Hospital Ratchasima
BMCE-Phoenix Hospital
Bangkok Hospital Pattaya
Royal Phnom Penh Hospital
Bangkok Hospital Headquarters
Samitivej Sukhumvit Hospital
Samitivej Srinakarin Hospital
Bangkok Hospital Phuket
Phyathai 2 Hospital

13. BDMS ASSIGNED CoE NETWORK HOSPITALS
BDMS Centers of Excellence Network
BHQ
SVH
SNH
PYT2
BCM
BUD
RPH
BPH
BPK
ASSIGNED
CoE

14. BDMS ASSIGNED CoE NETWORK
BDMS Centers of Excellence Network
ASSIGNED
SPECIALTY
BRAIN
HEART
CANCER
TRAUMA
BONES

15. BDMS ASSIGNED CoE NETWORK HOSPITALS
BDMS Centers of Excellence Network
Heart CoE
BHQ
SVH
PYT2
BCM
BPH
BPK

16. BDMS Heart CoE
BHQ - Bangkok Hospital Headquarter
BPH - Bangkok Pattaya Hospital
BPK Bangkok Hospital Phuket
PT Phyathai 2 Hospital
BCM - Bangkok Chiang Mai Hospital
SVH Samitivej Hospital
BKH Bangkok Ratchasima Hospital

17. International Affiliation
Oregon Health and Science University (OHSU)
MD Anderson Cancer Center (MDACC)
Cedar Sinai Neuroscience Center
Stanford Orthopedics
University of Missouri
Hannover University, Germany

18. Presentation outline
Thailand healthcare system
Thailand healthcare coverage
BDMS history of expansion
BDMS hub and spoke model – network
Birth of BDMS CoE, BDMS Heart CoE
Affiliation program, Domestic and International

19. Thank You
CoE Heart Institute