Healthcare System and Delivery Network – 2010 Yearbook

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					     Healthcare System and Delivery Network – 2010 Yearbook
 Reference Code: GBIHC059MR                                                                            Publication Date: December 2010


                                    Tremendous Variation in Healthcare Expenditure across Geographies
  Healthcare expenditure as         Healthcare expenditure as a percentage of Gross Domestic Product (GDP) has been increasing
  a percentage of Gross             consistently and differs variably across geographies. An international comparison on healthcare
  Domestic Product (GDP)            spending in 2008 demonstrated that the US spent significantly higher than any other developed
  differs variably across           and emerging countries. In 2008, healthcare spending as a percentage of GDP in the US was 16%,
  geographies. The US               it was 11.2% in France, 9.1% in Italy, 10.5% in Germany, 9% in Spain, 8.7% in the UK, 4.7% in
  spends significantly higher       China, 5% in India and 8% in Brazil. Japan spent 8.1% of its GDP on healthcare in 2007. An
  than any other developed          increase in elderly population, a rise in chronic diseases, medical technological advancements, and
  and emerging countries.           the growing expectations of patients, have all contributed towards increasing health care
                                    expenditures. The global share of health expenditure as a percentage of GDP is likely to increase
                                    further as countries recover from the global recession that hit many countries in 2008 and became
                                    widespread in 2009. The distribution of health expenditure across the different types of health
                                    services and medical goods is influenced by factors such as the availability of hospital beds, health
                                    professionals and access to new technology and healthcare providers, as well as by national
                                    clinical guidelines and the disease burden within the country.
                                    Healthcare Expenditure Per Capita on Public, Private and Out-Of Pocket Payments is
                                    Highest in the US
                                    The per capita expenditure on healthcare has been consistently higher in the US than in any other
                                    industrialized nation. In 2008, per capita spending on healthcare was $7,538 in the US, $3,693 in
                                    France, $2,870 in Italy, $3,737 in Germany, $2,902 in Spain and $3,129 in the UK. Japan spent
                                    $2,729 per capita on healthcare in 2007. Although healthcare expenditure as a percentage of GDP
                                    has been increasing, there has not been a significant rise in the per capita health expenditure in
                                    China, India and Brazil because of the high population growth in these countries.
                                    In the developed countries of Europe and in Japan, a major proportion of the healthcare
                                    expenditure is funded by the government. However, in the US, where the market is dominated by
                                    private players, the government funding represents close to 46.5% of the total healthcare
                                    expenditure. In 2008, public spending on healthcare per capita was lowest in the US (46.5%) and
                                    highest in the UK (82.6%). While public spending in the US was $3,507 per capita, the UK spent
                                    $2,585 per capita. Public spending on healthcare per capita in the other European countries was
                                    $2,875 in France, $2,216 in Italy, $2,869 in Germany and $2,105 in Spain. Japan spent a total of
                                    $2,729 per capita on healthcare in 2007. Out-of-pocket payments were the highest in the US and
                                    lowest in France in 2008.




Healthcare System and Delivery Network – 2010 Yearbook                                                   GBIHC059MR / Published DEC 2010
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                                     Healthcare Expenditure, Per Capita by Source of Funding ($), 2008

                                                                             8,000   $7,538


                                                                             7,000    912



                                                                             6,000


                                        Health Expenditure, per capita ($)
                                                                             5,000   3,119



                                                                             4,000                                      $3,696          $3,737

                                                                                                                         273             487                                         $3,129
                                                                                                                         548                            $2,870        $2,902
                                                                             3,000                    $2,729                             381                                          347
                                                                                                                                                         558            602           197
                                                                                                        399
                                                                                                         96                                               96            195
                                                                             2,000
                                                                                     3,507
                                                                                                                        2,875            2,869
                                                                                                                                                                                     2,585
                                                                             1,000                     2,234                                            2,216          2,105



                                                                                0
                                                                                       US             Japan *           France         Germany           Italy         Spain          UK

                                                                                            Public health expenditure            Private health expenditure         Out-of-Pocket Payment

                                     Source: GBI Research, OECD Health Data, 2010
                                     Note: Japan* - 2007 data




                                    Increases In Elderly Populations Will Drive the Healthcare Delivery Market In Future
                                    As the global population grows, the demand for healthcare will increase. According to demographic
                                    projections, the proportion of the global population aged 65 and above will increase drastically by
                                    2020. The rapidly increasing number of elderly people will demand health care and aging-related
                                    services. The risk of developing chronic diseases increases with age. About 80% of older adults
                                    have one chronic condition, and 50% have at least two. Chronic conditions such as Cardiovascular
                                    Diseases (CVD), cancer and respiratory disorders were the most common cause of death in the
                                    elderly across geographies. According to the United Nations projections, about 16.1% of the total
                                    population in the US, 28.5% of Japan’s population, 20.9% of the population in France, 23% of
                                    Italy’s population, 23% of Germany’s population, 18.7% of Spain’s population, and 18.5% of the
                                    total population in the UK will be aged 65 and above in 2020. The percentage of elderly population
                                    in the emerging countries will be less compared to the developed countries. About 9.6% the total
                                    population in Brazil, 5.7% of India’s population and 11.7% of China’s population will be aged 65
                                    and above in 2020.
                                    The two most widely used measures to evaluate healthcare outcomes are life expectancy and
                                    infant mortality rate. The life expectancy in Japan was 82.1 years and the infant mortality rate was
                                    2.79 deaths per 1,000 live births. Japan’s figures for these two measures were the highest and
                                    lowest in the world in 2009. This indicates that the country has a very healthy population. Although
                                    the US spent 51% more on healthcare as a percentage of GDP than Japan, life expectancy in the
                                    US was 78.1 years. This suggests that increased healthcare expenditure alone does not
                                    necessarily result in better life expectancy.




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                                    Reimbursement of Health Care Services Varies Across Geographies
                                    The developed countries of Europe and Japan have a government-funded healthcare system in
                                    which a major portion of the healthcare costs are reimbursed by the government. Medical goods
                                    and services that qualify for reimbursement by the health insurance system include in-patient and
                                    out-patient costs, diagnostic tests, pharmaceutical products, dental care, rehabilitation,
                                    physiotherapy and healthcare-related transport. Reimbursements and co-payments vary across
                                    geographies and for each health insurance plan specific to a country.
                                    Co-payments may be defined as out-of pocket payments made by the patient for accessing a
                                    medical service or medical goods usage not covered by the insurance provider. These may include
                                    doctor’s appointments and consultation fees, hospital stays, medical tests and prescription drugs.
                                    While co-payments may be an effective cost-containment measure, the disadvantage is that it may
                                    discourage patients from seeking essential medical care.
                                    In the UK, the publicly funded basic health plan that provides health insurance to all citizens covers
                                    100% of the in-patient costs, out-patient costs and pharmaceutical products. A major share of
                                    dental costs is also covered by the national health plan while the rest of the costs are paid by the
                                    patients as co-payments. A similar scenario exists for in-patient; out-patient and pharmaceutical
                                    drug costs coverage in Italy, with the exception of dental care that requires a co-payment. In Spain,
                                    dental treatment is not covered by the national health plan.

                                     Reimbursement of Health Care Services, by Functions of Care, 2008-2009


                                                                 In-patient care     Out-patient care     Pharmaceuticals        Dental care


                                                               Co-payment,         Co-payment,          Co-payment,           Co-payment,
                                          France               76-99%              51-75%               51-75%                1-50%


                                                               Co-payment          Co-payment,          Co-payment,           Co-payment,
                                                               ~100%               76-99%               76-99%                76-99%
                                          Germany

                                                               No co-payment,      No co-payment,       No co-payment,        Co-payment
                                                               100%                76-99%               100%
                                          Italy

                                                               No co-payment,      No co-payment,       Co-payment,           Not covered
                                                               100%                100%                 76-99%
                                          Spain

                                                               No co-payment,      No co-payment,       No co-payment,        Co-payment,
                                                               100%                100%                 100%                  76-99%
                                          UK

                                                               Co-payment,         Co-payment,          Co-payment,           Co-payment,
                                          Japan                51-75%              51-75%               51-75%                51-75%



                                     Source: GBI Research, OECD Survey of Health System Characteristics 2008-2009




Healthcare System and Delivery Network – 2010 Yearbook                                                              GBIHC059MR / Published DEC 2010
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                                    1         Table of Contents
                                    1 Table of Contents ........................................................................................................................ 4
                                      1.1    List of Tables................................................................................................................... 10
                                      1.2    List of Figures ................................................................................................................. 12
                                    2 Healthcare System and Delivery Network: Introduction ............................................................. 14
                                      2.1    GBI Research Guidance ................................................................................................. 14
                                    3 Healthcare Delivery System in the US ....................................................................................... 16
                                      3.1    Introduction ..................................................................................................................... 16
                                      3.2    Healthcare Expenditure .................................................................................................. 16
                                         3.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 17
                                         3.2.2    Healthcare Expenditure by Category ....................................................................... 18
                                         3.2.3    Health Care Expenditure per Capita by Source of Funding ..................................... 20
                                      3.3    Healthcare Infrastructure ................................................................................................ 22
                                         3.3.1    Healthcare Providers ............................................................................................... 22
                                         3.3.2    Hospital Beds .......................................................................................................... 23
                                         3.3.3    Healthcare Professionals ......................................................................................... 24
                                      3.4    Healthcare System .......................................................................................................... 24
                                         3.4.1    Health Insurance Providers ..................................................................................... 25
                                         3.4.2    Healthcare Regulation ............................................................................................. 29
                                         3.4.3    Sources of Funding ................................................................................................. 32
                                      3.5    Key Players in the Healthcare Industry ........................................................................... 33
                                         3.5.1    Mayo Clinic .............................................................................................................. 33
                                         3.5.2    Johns Hopkins Hospital ........................................................................................... 33
                                         3.5.3    Cleveland Clinic ....................................................................................................... 34
                                      3.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ........................ 35
                                         3.6.1    High Population Growth ........................................................................................... 35
                                         3.6.2    Disease Profile ........................................................................................................ 36
                                      3.7    The US Healthcare Delivery Opportunities ..................................................................... 37
                                         3.7.1    Health Information Technology (HIT) Will Make Healthcare Delivery Safer, More
                                                  Effective and More Efficient ..................................................................................... 37
                                         3.7.2    Rapid Uptake of Generic Drugs Will Reduce Prescription Drug Spending .............. 37
                                      3.8    The US Healthcare Delivery Challenges ......................................................................... 38
                                         3.8.1    High Cost of Prescription Drugs Encourages Patients to Forgo Treatment ............. 38
                                         3.8.2    Decreasing Employment-based Health Insurance Coverage Increases the Number
                                                  of Uninsured ............................................................................................................ 38
                                    4 Healthcare Delivery System in Japan ........................................................................................ 39
                                      4.1    Introduction ..................................................................................................................... 39
                                      4.2    Healthcare Expenditure .................................................................................................. 39
                                         4.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 39
                                         4.2.2    Healthcare Expenditure by Category ....................................................................... 40
                                         4.2.3    Health Care Expenditure per Capita by Source of Funding ..................................... 41
                                      4.3    Healthcare Infrastructure ................................................................................................ 42
                                         4.3.1    Healthcare Providers ............................................................................................... 42
                                         4.3.2    Hospital Beds .......................................................................................................... 43
                                         4.3.3    Healthcare Professionals ......................................................................................... 44
                                      4.4    Healthcare System .......................................................................................................... 44
                                         4.4.1    Health Insurance Providers ..................................................................................... 45
                                         4.4.2    Healthcare Regulation ............................................................................................. 47
                                         4.4.3    Sources of Funding ................................................................................................. 48
                                      4.5    Key Players in the Healthcare Industry ........................................................................... 48
                                      4.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ........................ 49
                                         4.6.1    High Population Growth ........................................................................................... 49
                                         4.6.2    Disease Profile ........................................................................................................ 50
                                      4.7    Healthcare Delivery Opportunities .................................................................................. 52


Healthcare System and Delivery Network – 2010 Yearbook                                                                            GBIHC059MR / Published DEC 2010
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                                         4.7.1    The Japanese Government Is Promoting HIT Adoption in Medical Institutions ....... 52
                                         4.7.2    Rapidly Aging Population Will Drive the Healthcare Market .................................... 52
                                      4.8    Healthcare Delivery Challenges ...................................................................................... 52
                                         4.8.1    Attention on Late-stage Diseases Rather Than Early Health .................................. 52
                                         4.8.2    Japan Has Abundance of Hospital Beds but Understaffed Hospitals ...................... 52
                                    5 Healthcare Delivery System in France ...................................................................................... 53
                                      5.1    Introduction ..................................................................................................................... 53
                                      5.2    Healthcare Expenditure .................................................................................................. 53
                                         5.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 53
                                         5.2.2    Healthcare Expenditure by Category ....................................................................... 54
                                         5.2.3    Healthcare Expenditure per Capita by Source of Funding ....................................... 55
                                      5.3    Healthcare Infrastructure ................................................................................................ 56
                                         5.3.1    Healthcare Providers ............................................................................................... 56
                                         5.3.2    Hospital Beds .......................................................................................................... 57
                                         5.3.3    Healthcare Professionals ......................................................................................... 57
                                      5.4    Healthcare System .......................................................................................................... 58
                                         5.4.1    Health Insurance Providers ..................................................................................... 58
                                         5.4.2    Healthcare Regulation ............................................................................................. 58
                                         5.4.3    Sources of Funding ................................................................................................. 61
                                      5.5    Key Players in the Healthcare Industry ........................................................................... 61
                                         5.5.1    CHU de Toulouse .................................................................................................... 61
                                         5.5.2    CHU de Bordeaux (Bordeaux University Hospital) .................................................. 61
                                      5.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ........................ 62
                                         5.6.1    High Population Growth ........................................................................................... 62
                                         5.6.2    Disease Profile ........................................................................................................ 63
                                      5.7    Healthcare Delivery Opportunities .................................................................................. 64
                                         5.7.1    Government Funding and Initiatives will Revive the Healthcare IT Market .............. 64
                                         5.7.2    The Research and Development Sector Is Mature and Growing Quickly ................ 64
                                      5.8    Healthcare Delivery Challenges ...................................................................................... 65
                                         5.8.1    High Rate of Premature Alcohol-Attributable Male Mortality .................................... 65
                                         5.8.2    High Unemployment Rate May Raise Tax Contributions ......................................... 65
                                    6 Healthcare Delivery System in Italy ........................................................................................... 66
                                      6.1    Introduction ..................................................................................................................... 66
                                      6.2    Healthcare Expenditure .................................................................................................. 66
                                         6.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 66
                                         6.2.2    Healthcare Expenditure per Capita by Source of Funding ....................................... 67
                                      6.3    Healthcare Infrastructure ................................................................................................ 68
                                         6.3.1    Healthcare Providers ............................................................................................... 68
                                         6.3.2    Hospital Beds .......................................................................................................... 69
                                         6.3.3    Healthcare Professionals ......................................................................................... 69
                                      6.4    Healthcare System .......................................................................................................... 69
                                         6.4.1    Health Insurance Providers ..................................................................................... 69
                                         6.4.2    Healthcare Regulation ............................................................................................. 70
                                         6.4.3    Sources of Funding ................................................................................................. 71
                                      6.5    Key Players in the Healthcare Industry ........................................................................... 71
                                         6.5.1    Centro Diagnostico Italiano (CDI) ............................................................................ 71
                                         6.5.2    Istituto Europeo di Oncologia (IEO) ......................................................................... 71
                                      6.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ........................ 73
                                         6.6.1    High Population Growth ........................................................................................... 73
                                         6.6.2    Disease Profile ........................................................................................................ 74
                                      6.7    Healthcare Delivery Opportunities .................................................................................. 75
                                         6.7.1    Home Healthcare Devices May Pose New Ways of Delivering Care ...................... 75
                                         6.7.2    Significant Demand for Medical Equipment Provides Opportunity for Growth ......... 75
                                      6.8    Healthcare Delivery Challenges ...................................................................................... 76



Healthcare System and Delivery Network – 2010 Yearbook                                                                            GBIHC059MR / Published DEC 2010
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                                            6.8.1 Significant Health Inequality among Regions Due to a Decentralized Healthcare
                                                  System .................................................................................................................... 76
                                         6.8.2    Wide Discrepancies in Public and Private Health Providers .................................... 76
                                    7 Healthcare Delivery System in Germany ................................................................................... 77
                                      7.1    Introduction ..................................................................................................................... 77
                                      7.2    Healthcare Expenditure .................................................................................................. 77
                                         7.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 77
                                         7.2.2    Healthcare Expenditure by Category ....................................................................... 78
                                         7.2.3    Healthcare Expenditure per Capita by Source of Funding ....................................... 79
                                      7.3    Healthcare Infrastructure ................................................................................................ 80
                                         7.3.1    Healthcare Providers ............................................................................................... 80
                                         7.3.2    Hospital Beds .......................................................................................................... 80
                                         7.3.3    Healthcare Professionals ......................................................................................... 80
                                      7.4    Healthcare System .......................................................................................................... 81
                                         7.4.1    Health Insurance Providers ..................................................................................... 81
                                         7.4.2    Healthcare Regulation ............................................................................................. 81
                                         7.4.3    Sources of Funding ................................................................................................. 83
                                      7.5    Key Players in the Healthcare Industry ........................................................................... 83
                                         7.5.1    DRK Kliniken Berlin (DRK Clinics Berlin) ................................................................. 83
                                         7.5.2    Stadtisches Klinikum Gorlitz gGmbH (Municipal Hospital Gorlitz gGmbH) .............. 83
                                      7.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ........................ 84
                                         7.6.1    High Population Growth ........................................................................................... 84
                                         7.6.2    Disease Profile ........................................................................................................ 85
                                      7.7    Healthcare Delivery Opportunities .................................................................................. 86
                                         7.7.1    The Chemical and Pharmaceutical Industry in Germany Is Highly Innovative ......... 86
                                         7.7.2    Home Healthcare Likely to Provide Cost-effective and Efficient Delivery of
                                                  Healthcare ............................................................................................................... 86
                                      7.8    Healthcare Delivery Challenges ...................................................................................... 87
                                         7.8.1    Pharmaceutical Drug Costs in Germany Are Among the Most Expensive In the
                                                  World ....................................................................................................................... 87
                                         7.8.2    Unhealthy Dietary Habits and Increasing Elderly Population Increases Risk of
                                                  Chronic Diseases .................................................................................................... 87
                                    8 Healthcare Delivery System in Spain ........................................................................................ 88
                                      8.1    Introduction ..................................................................................................................... 88
                                      8.2    Healthcare Expenditure .................................................................................................. 88
                                         8.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 88
                                         8.2.2    Healthcare Expenditure by Category ....................................................................... 89
                                         8.2.3    Healthcare Expenditure per Capita by Source of Funding ....................................... 90
                                      8.3    Healthcare Infrastructure ................................................................................................ 91
                                         8.3.1    Healthcare Providers ............................................................................................... 91
                                         8.3.2    Hospital Beds .......................................................................................................... 91
                                         8.3.3    Healthcare Professionals ......................................................................................... 92
                                      8.4    Healthcare System .......................................................................................................... 92
                                         8.4.1    Health Insurance Providers ..................................................................................... 92
                                         8.4.2    Healthcare Regulation ............................................................................................. 93
                                         8.4.3    Sources of Funding ................................................................................................. 94
                                      8.5    Key Players in the Healthcare Industry ........................................................................... 94
                                         8.5.1    The Hospital La Paz ................................................................................................ 94
                                         8.5.2    Hospital de Torrevieja .............................................................................................. 94
                                      8.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ........................ 95
                                         8.6.1    High Population Growth ........................................................................................... 95
                                         8.6.2    Disease Profile ........................................................................................................ 96
                                      8.7    Healthcare Delivery Opportunities .................................................................................. 98
                                         8.7.1    EMRs Will Help Deliver Healthcare Better through a Unified Database Created by
                                                  the Autonomous Communities................................................................................. 98


Healthcare System and Delivery Network – 2010 Yearbook                                                                            GBIHC059MR / Published DEC 2010
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                                          8.7.2    Increase In Diabetes Prevalence Will Drive the Diabetes Care Devices Market ..... 98
                                       8.8    Healthcare Delivery Challenges ...................................................................................... 98
                                          8.8.1    Healthcare Delivery Varies Due to a Decentralized Healthcare System .................. 98
                                          8.8.2    Immigrants Compete With Local People for Health Services .................................. 98
                                    9 Healthcare Delivery System in the UK ....................................................................................... 99
                                       9.1    Introduction ..................................................................................................................... 99
                                       9.2    Healthcare Expenditure .................................................................................................. 99
                                          9.2.1    Healthcare Expenditure as a Share of GDP ............................................................ 99
                                          9.2.2    Healthcare expenditure per Capita by Source of Funding ..................................... 100
                                       9.3    Healthcare Infrastructure .............................................................................................. 101
                                          9.3.1    Healthcare Providers ............................................................................................. 101
                                          9.3.2    Hospital Beds ........................................................................................................ 101
                                          9.3.3    Healthcare Professionals ....................................................................................... 101
                                       9.4    Healthcare System ........................................................................................................ 101
                                          9.4.1    Health Insurance Providers ................................................................................... 102
                                          9.4.2    Healthcare Regulation ........................................................................................... 103
                                          9.4.3    Sources of Funding ............................................................................................... 103
                                       9.5    Key Players in the Healthcare Industry ......................................................................... 104
                                          9.5.1    Royal National Orthopaedic Hospital NHS Trust (RNOH) ..................................... 104
                                          9.5.2    Royal Brompton & Harefield NHS Trust ................................................................ 104
                                       9.6    Socio-Economic and Demographic Trends Affecting Healthcare Sector ...................... 105
                                          9.6.1    High Population Growth ......................................................................................... 105
                                          9.6.2    Disease Profile ...................................................................................................... 106
                                       9.7    Healthcare Delivery Opportunities ................................................................................ 107
                                          9.7.1    NHS Connecting for Health will provide secure and audited access to patient’s
                                                   medical records ..................................................................................................... 107
                                          9.7.2    DH Proposal Will Drive Generic Drugs Market ...................................................... 107
                                          9.7.3    NHS Plans to Outsource Health Services to Private Health Firms ........................ 108
                                       9.8    Healthcare Delivery Challenges .................................................................................... 108
                                          9.8.1    Rising Healthcare Costs Encourage Thousands to Travel Abroad For Treatment 108
                                          9.8.2    Uneven Prescription Costs across the UK ............................................................. 108
                                    10 Healthcare Delivery System in India ........................................................................................ 109
                                       10.1 Introduction ................................................................................................................... 109
                                       10.2 Healthcare Expenditure ................................................................................................ 109
                                       10.3 Healthcare Infrastructure .............................................................................................. 110
                                          10.3.1 Public Healthcare Infrastructure ............................................................................ 112
                                          10.3.2 Private Healthcare infrastructure ........................................................................... 113
                                       10.4 Healthcare Regulation .................................................................................................. 115
                                          10.4.1 The Union Ministry of Health and Family Welfare (MoHFW) ................................. 115
                                          10.4.2 National Programs and Schemes .......................................................................... 116
                                          10.4.3 Highlights of Budget 2010-2011 ............................................................................ 118
                                          10.4.4 Health Insurance Regulation ................................................................................. 119
                                       10.5 Key Players in the Healthcare Industry ......................................................................... 119
                                          10.5.1 Apollo Hospitals Enterprise Ltd.............................................................................. 119
                                          10.5.2 Fortis Healthcare ................................................................................................... 120
                                          10.5.3 Manipal Health Systems ........................................................................................ 121
                                          10.5.4 Max Healthcare ..................................................................................................... 121
                                          10.5.5 Narayana Hrudayalaya .......................................................................................... 121
                                          10.5.6 Columbia Asia ....................................................................................................... 122
                                          10.5.7 Profiles of New Entrants ........................................................................................ 122
                                       10.6 Sources of Funding ....................................................................................................... 123
                                          10.6.1 Foreign Direct Investment (FDI) & other Foreign Investments .............................. 123
                                          10.6.2 Private Equity and Venture Capital ........................................................................ 124
                                       10.7 Evolving Trends in the Healthcare System in India ....................................................... 125
                                          10.7.1 Health Cities .......................................................................................................... 125

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                                          10.7.2 Hospotels .............................................................................................................. 126
                                          10.7.3 Health and Wellness .............................................................................................. 126
                                       10.8 Socio-Economic and Demographic Trends Affecting Healthcare Sector ...................... 127
                                          10.8.1 High Population and Economic Growth ................................................................. 127
                                          10.8.2 Emergence of the Middle Class ............................................................................. 128
                                          10.8.3 Shift in Disease profile ........................................................................................... 128
                                       10.9 Reimbursement Scenario.............................................................................................. 129
                                          10.9.1 Private Health Insurance ....................................................................................... 129
                                       10.10 India Healthcare Delivery Opportunities ........................................................................ 133
                                          10.10.1 Medical Tourism .................................................................................................... 133
                                          10.10.2 Investments in Healthcare Infrastructure ............................................................... 134
                                          10.10.3 Increase in Foreign Direct Investment (FDI) .......................................................... 134
                                          10.10.4 Telemedicine ......................................................................................................... 135
                                          10.10.5 Opportunities in Medical Equipments Industry....................................................... 135
                                          10.10.6 Health Insurance ................................................................................................... 136
                                       10.11 India Healthcare Delivery Challenges ........................................................................... 136
                                          10.11.1 Financial Disparity ................................................................................................. 136
                                          10.11.2 Weak Infrastructure ............................................................................................... 136
                                          10.11.3 Intellectual Property (IP) Concerns ........................................................................ 136
                                    11 Healthcare Delivery System in China ...................................................................................... 137
                                       11.1 Introduction ................................................................................................................... 137
                                       11.2 Healthcare Expenditure ................................................................................................ 137
                                       11.3 Healthcare Infrastructure .............................................................................................. 138
                                          11.3.1 Public and Private Sector Scenario ....................................................................... 142
                                          11.3.2 Impact of Healthcare Reforms, 2009 ..................................................................... 144
                                       11.4 Healthcare Regulation .................................................................................................. 146
                                          11.4.1 Ministry of Health ................................................................................................... 147
                                          11.4.2 The National Development and Reform Commission (NDRC) .............................. 148
                                          11.4.3 Chinese Center for Disease Control and Prevention (China CDC)........................ 148
                                          11.4.4 The Ministry of Finance (MoF) ............................................................................... 148
                                          11.4.5 Ministry of Labor and Social Security (MoLSS) ..................................................... 148
                                       11.5 Profiles of Key Players .................................................................................................. 149
                                          11.5.1 United Family Hospitals Group (UFH) ................................................................... 149
                                          11.5.2 Parkway Health, China .......................................................................................... 149
                                          11.5.3 Sunnylife Global, Inc. ............................................................................................. 149
                                          11.5.4 Sino-German Friendship Hospital.......................................................................... 149
                                          11.5.5 SK Group ............................................................................................................... 150
                                          11.5.6 Shanghai East International Medical Center ......................................................... 150
                                          11.5.7 Global Doctor......................................................................................................... 150
                                       11.6 Sources of Funding ....................................................................................................... 150
                                          11.6.1 Private, Share holdings and Sino-foreign Joint Venture Hospitals......................... 150
                                       11.7 Evolving Trends in the Healthcare System in China ..................................................... 152
                                          11.7.1 Increase in Taiwanese Investment in Hospitals in China ....................................... 152
                                          11.7.2 Hospital Advertising ............................................................................................... 152
                                       11.8 Socio-Economic and Demographic Trends Affecting the Healthcare Sector ................ 153
                                          11.8.1 Shift in Demographics ........................................................................................... 153
                                          11.8.2 Rise in Personal Disposable Income ..................................................................... 154
                                          11.8.3 Rise in Lifestyle Diseases ...................................................................................... 155
                                       11.9 Reimbursement Scenario.............................................................................................. 155
                                       11.10 China Healthcare Delivery Opportunities ...................................................................... 158
                                          11.10.1 High growth in Medical Equipment Market ............................................................ 158
                                          11.10.2 Growth in Pharmaceutical Industry Sector ............................................................ 159
                                          11.10.3 Booming Healthcare Construction Market ............................................................. 159
                                          11.10.4 Opportunity in Hospital Information Systems Sector ............................................. 159
                                       11.11 China Healthcare Delivery Challenges ......................................................................... 159

Healthcare System and Delivery Network – 2010 Yearbook                                                                           GBIHC059MR / Published DEC 2010
                                                                                                                                                                      Page 8
                                                                                     © GBI Research. This is a licensed product and is not to be photocopied
                                          11.11.1 Regulatory and Bureaucratic issues ...................................................................... 159
                                          11.11.2 Weak Intellectual Property Protection .................................................................... 159
                                          11.11.3 High Cost of Prescription Drugs ............................................................................ 160
                                          11.11.4 Financial Disparity and Coverage Problems .......................................................... 160
                                          11.11.5 Inadequate Infrastructure and Qualified Workforce ............................................... 160
                                          11.11.6 Language Barrier ................................................................................................... 160
                                    12 Healthcare Delivery System in Brazil ....................................................................................... 161
                                       12.1 Introduction ................................................................................................................... 161
                                       12.2 Healthcare Expenditure ................................................................................................ 161
                                       12.3 Healthcare Infrastructure .............................................................................................. 162
                                          12.3.1 Public and Private Sector Scenario ....................................................................... 164
                                       12.4 Healthcare Regulation .................................................................................................. 165
                                          12.4.1 Unified Health System (UHS also called as SUS in Brazil) ................................... 165
                                          12.4.2 National Agency of Sanitary Surveillance (ANVISA) ............................................. 166
                                          12.4.3 National Private Healthcare Insurance Agency (ANS) ........................................... 166
                                       12.5 Profiles of Key Players .................................................................................................. 167
                                          12.5.1 Rede D’Or (D’Or’ or ‘The Company’) ..................................................................... 167
                                          12.5.2 Sao Luiz ................................................................................................................ 168
                                          12.5.3 HCor – Hospital do Coracao ...........................................
				
DOCUMENT INFO
Description: Healthcare System and Delivery Network – 2010 Yearbook Summary GBI Research’s new report, “Healthcare System and Delivery Network – 2010 Yearbook” provides key data, information and analysis on the Healthcare Delivery in both developed and emerging economies. The report provides market landscape, competitive landscape and market trends information on Healthcare Delivery in the US, Japan, France, Italy, Germany, Spain, the UK India, China and Brazil. The report provides comprehensive information on the key trends affecting healthcare delivery, and key analytical content on the market dynamics. The report also reviews the competitive landscape and technology offerings. This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GBI Research’s team of industry experts. Scope The scope of this report includes: - Overall national healthcare expenditure, expenditure by category and public versus private spending. - The next section gives a detailed account of the healthcare infrastructure, including the healthcare providers, hospitals bed size and healthcare professionals. - The following section gives details on the healthcare system, health insurance providers, regulation and sources of funding impacting the healthcare system and delivery network in the US, Japan, France, Italy, Germany, Spain, the UK India, China and Brazil. - This is followed by profiles of key market players in the US, Japan, France, Italy, Germany, Spain, the UK India, China and Brazil. - The sixth section gives details on the socio-economic and demographic trends affecting the healthcare sector. It also gives information on the leading causes of death in the US, Japan, France, Italy, Germany, Spain, the UK India, China and Brazil. - The last section of this chapter discusses the key healthcare delivery opportunities and challenges in the US, Japan, France, Italy, Germany, Spain, the UK India, China an
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