China Hospital Industry Development and Investment Report, 2009-2010
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Under the influence of social demand and continuous government investment, China’s hospital industry has experienced rapid development in recent years, and increased its revenue from RMB423.8 billion in 2005 to RMB859.5 billion in 2009 at a CAGR of 19.3%. Especially, China has issued policies to encourage diversified hospital investors and investment approaches, which has promoted the development of non-state-owned hospitals greatly. From 2005 to 2009, the number of non-state-owned hospitals increased substantially from 3,220 to 6,240 at a CAGR of 18.0%, while the number of state-owned hospitals had been declining. As of the end of 2009, non-state-owned hospitals had accounted for 30.8% of the total number of hospitals in China.

Number and Growth Rate of State-owned and Non-state-owned Hospitals in China, 2005-2009
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Source: ResearchInChina; Ministry of Health of PRC

On December 3, 2010, China issued Opinions on Further Encouraging and Guiding Investment of Social Capital in Medical Institutions to further clarify the attitude of Chinese government toward opening up the hospital industry. The Opinions provides a fairer environment for non-state-owned hospitals by loosening the approval of medicare-designated non-state-owned hospitals and for the first time allowing the establishment of foreign-owned hospitals, and so on. In the future, it will be inevitable that state-owned hospitals, private hospitals and foreign hospitals will bolster China’s hospital industry, and particularly, private and foreign hospitals will have better prospects.

1. Private hospitals. Private hospitals are mostly specialized hospitals and regional medical groups, with low market concentration. Although private hospitals are confronted with the development bottleneck of high tax rate, lack of professionals and policy support, they have been developing rapidly since Chinese medical market demand has kept increasing in recent years.

Take Aier Eye Hospital Group as an example. As a Medicare-designated hospital, it has expanded its business quickly in China through its unique three-level chain business model. In 2009, its total income valued RMB606 million, up 38.1% year on year, and its gross profit margin was 57.1%; eye care services reaped RMB447 million, accounting for 73.8% of the total revenue. Specially, excimer laser eye surgery and cataract surgery contributed 44.1% and 24.4% to the total medical service revenue respectively.

2. Foreign hospitals. Foreign hospitals have powerful financial strength, with good management and brand advantage. In recent years, they have developed well in the field of high-end medical services for foreigners in China. However, the foreigner-oriented market potential is limited, therefore, with China's economic development, foreign hospitals are penetrating into medium and high-class families in China.

Among foreign hospitals, CHINDEX United Family Hospital and Clinics is the most successful in China. Its success lies in its profound understanding of Chinese culture and policies. It targets at medium and high-end medical service market, and implement localization and differentiation strategies. In 2009, its operating income was USD85.78 million, up 8.1% year on year; its gross profit valued USD19.31 million with a gross profit margin of 22.5%, an increase of seven percentage points compared with 2008. In 1998, most of its patients were foreigners and people from Hong Kong, Macao and Taiwan, and mainland Chinese patients accounted for less than 1/10; by 2008, mainland Chinese patients had accounted for more than 50%.

Based on the overall development and policy environment of China’s hospital industry, this report analyzes the overall situation and development trend of private and foreign hospitals in China, the operation and development strategies of 12 typical private hospitals (including Beijing Phoenix Hospital Group, Shenzhen BOAI Hospital Group, Aier Eye Hospital Group, Topchoice Dental Medical, and Concord Medical Services) and three typical foreign hospitals (United Family Hospital, Parkway Group Healthcare, and Chang Gung Memorial Hospital), as well as the investment and main risks in China’s hospital industry.

1. Overview of China Hospital Industry 
1.1 Definition and Classification
1.2 Industry Chain
1.3 Development Overview
1.4 Regional Development

2. Overview of Chinese Hospital Market 
2.1 American Hospital Market
2.1.1 Growing Medical Expenses 
2.1.2 Strong Market Demand 
2.1.3 Hospital Management and Revenue 
2.2 Chinese Hospital Market
2.2.1 Fast-growing Medical Expenses
2.2.2 Increasing Government Investment
2.2.3 Market Growth Driven by an Aging Population
2.2.4 Rapid Income Growth Supported by Medicine Business of Hospitals
2.2.5 Obvious Contradiction between Supply and Demand 
2.2.6 State-owned Hospital-dominated Competition Pattern

3. Chinese Hospital Policies
3.1 New Medical Reform Stimulates Market Demand
3.2 Many Policies Encourage Social Capital to Enter Hospital Industry

4. Development of Private Hospitals in China
4.1 Status Quo
4.2 Bottleneck
4.2.1 High Tax Burden
4.2.2 Discriminatory Policy 
4.2.3 Lack of Medical Professionals
4.3 Development Opportunities
4.4 Development Direction
4.5 Private Hospital Groups
4.5.1 Beijing Phoenix Hospital Group
4.5.2 Shenzhen BOAI Medical Group
4.5.3 Renai Hospital of Guangzhou
4.6 Private Medical and Health Care Management Industry
4.6.1 Ciming Checkup
4.6.2 iKang Guobin

5. Development of Private Specialized Hospitals in China
5.1 High-speed Development
5.2 Operation
5.3 Eye Hospitals
5.3.1 Overview
5.3.2 Aier Eye Hospital Group
5.4 Stomatological Hospitals
5.4.1 Overview
5.4.2 Topchoice
5.4.3 Arrail
5.5 Plastic Surgery and Cosmetic Hospitals 
5.5.1 Overview
5.5.2 EverCare Cosmetic Hospital
5.6 Maternity Hospitals
5.6.1 Overview
5.6.2 Beijing Bosheng Medical Group
5.7 Children's Hospitals
5.7.1 Overview
5.7.2 Beijing New Century International Children's Hospital
5.8 Cancer Hospitals
5.8.1 Overview
5.8.2 Concord Medical Services Holdings Limited (CMS)

6. Development of Foreign Hospitals in China
6.1 Status Quo
6.2 Operating Model
6.3 Development Direction
6.4 CHINDEX United Family Hospital and Clinics
6.5 Singapore Parkway Group Healthcare
6.6 Xiamen Chang Gung Memorial Hospital 

7. Investment in China Hospital Industry
7.1 Scale and Rounds
7.2 Regions
7.3 Cases
7.3.1 SBCVC Invests in D.A. Medical
7.3.2 Tiantu Capital Invests in Ciming Checkup
7.3.3 Qiming Venture Partners Invests in Arrail Dental
7.4 IPO in China Hospital Industry

8. Investment Risks in China Hospital Industry
8.1 Policy and Regulation
8.2 Litigation and Compensation for Medical Malpractice 
8.3 Social Awareness
Property Rights and Operating Model of Hospitals in China
Classification of Hospitals in China
Hospital Industry Chain
Total Number and Growth Rate of Hospitals in China, 2005-2010
Hierarchical Structure of Hospitals in China, 2010
Number and Growth Rate of State-owned and Non-state-owned Hospitals in China, 2005-2009
Growth Comparison between State-owned and Non-state-owned Hospitals in China, 2005-2009
Number and Growth Rate of Profit and Nonprofit Hospitals in China, 2005-2009   
Incremental Contribution of Profit and Nonprofit Hospitals in China, 2005-2009
Number and Growth Rate of General Hospitals, TCM Hospitals and Specialized Hospitals in China, 2005-2009
Number of Hospitals in China by Region, 2009
Number of Doctors Per 1,000 Patients in China by Region, 2009
Hospital Bed Utilazation Rate in China by Region, 2009
Proportion of Medical Expenses to GDP in USA, 2000-2009
Number and Proportion of People Aged 65 and Above in USA, 1980-2050
Comparison between European Hospitals and American Hospitals by Operating Model, 2008
Comparison between Chinese Hospitals and American Hospitals by Revenue Structure, 2008
Health Care Expenditure and Its Proportion in GDP in China, 2000-2009
Per Capita Health Care Expenditure and Growth Rate in China, 2000-2009
Per Capita Health Care Expenditure in Major Countries, 2007
Government, Social and Personal Health Care Expenditure, 2000-2009 
Number and Growth Rate of Urban Health Insurance Participants in China, 2000-2009
Number and Proportion of New Rural Cooperative Medical Insurance Participants in China, 2000-2009
Urban and Rural Health Care Expenditure and Proportion, 2000-2009
Number and Proportion of People Aged 65 and Above in China, 1982-2009
Revenue and Expenditure in China Hospital Industry, 2005-2009
Revenue and Growth Rate of General Hospitals in China, 2002-2009
Revenue of General Hospitals in China by Business and Proportion of Medicine Revenue, 2002-2009
Average Medicine Revenue & Expenditure and Mark-up Rate of General Hospitals in China, 2005-2009
"Separation of Pharmacy from Hospital" Reform in Wuhu
Number and Growth Rate of Patients of Hospitals in China, 2005-2009
Number and Utilization of Beds of Hospitals in China, 2005-2009
Number of Practicing Doctors and Registered Nurses of Hospitals in China, 2005-2009
Number and Growth Rate of Medical Graduates in China, 2005-2009
Proportion of Medical Staff Salary to Hospitals' Total Expenditure by Country, 2006
Proportion of State-owned and Non-state-owned Hospitals in China by Field, 2009
Proportion of Profit and Nonprofit Hospitals in China by Field, 2009
Policies of New Medical Reform
Chinese Policies Encouraging Investment of Social Capital in Hospital Industry
Proportion of State-owned and Non-state-owned Hospitals in China by Speciality, 2009
Comparison between Profit and Nonprofit Hospitals in China by Taxation
Comparision between Profit and Nonprofit Hospitals in Guangdong by Business, 2004
Six Operating Models of Beijing Phoenix Hospital Group
Raised Funds and Transferred Shares in Three Rounds of Financing of Ciming Checkup
Number and Growth Rate of Specialized Hospitals in China, 2005-2009
Revenue and Growth Rate of Specialized Hospitals in China, 2005-2009
Proportion of State-owned and Non-state-owned Specialized Hospitals in China, 2006-2009
Number and Proportion of Chinese Specialized Hospitals, 2009
Revenue and Proportion of Chinese Specialized Hospitals, 2009
Average Revenue of Chinese Specialized Hospitals, 2009
Profit Margin of Chinese Specialized Hospitals, 2009
Number and Growth Rate of Chinese Eye Hospitals, 2006-2009       
Revenue and Profit of Chinese Eye Hospitals, 2006-2009               
Bed Utilization and Efficiency of Doctor Services of Chinese Eye Hospitals, 2006-2009            
Operating Income, Gross Profit Margin and Revenue Growth Rate of Aier Eye Hospital Group, 2006-2010                  
Medical Service Revenue of Aier Eye Hospital Group, 2009 
Eye Hospitals, Outpatient Volume of Aier Eye Hospital Group and Its Proportion in China’s Hospital Ophthalmology, 2006-2009
Number and Growth Rate of Chinese Dental Hospitals, 2006-2009
Revenue and Profit of Chinese Dental Hospitals, 2006-2009
Bed Utilization and Efficiency of Doctor Services of Chinese Dental Hospitals, 2006-2009      
Major Subsidiaries of Topchoice, 2010
Operating Income, Gross Profit Margin and Revenue Growth Rate of Topchoice, 2006-2010
Number and Growth Rate of Chinese Plastic Surgery and Cosmetic Hospitals, 2006-2009        
Revenue and Profit of Chinese Plastic Surgery and Cosmetic Hospitals, 2006-2009               
Number and Growth Rate of Chinese Maternity Hospitals, 2006-2009
Revenue and Profit of Chinese Maternity Hospitals, 2006-2009
Bed Utilization and Efficiency of Doctor Services of Chinese Maternity Hospitals, 2006-2009
Number and Growth Rate of Chinese Children’s Hospitals, 2006-2009
Revenue and Profit of Chinese Children’s Hospitals, 2006-2009
Bed Utilization and Efficiency of Doctor Services of Chinese Children’s Hospitals, 2006-2009     
Number and Growth Rate of Chinese Cancer Hospitals, 2006-2009        
Revenue and Profit of Chinese Cancer Hospitals, 2006-2009
Bed Utilization and Efficiency of Doctor Services of Chinese Cancer Hospitals, 2006-2009    
Total Revenue, Gross Profit Margin and Growth Rate of CMS Holdings Ltd, 2006-2010
Some Joint Venture Hospitals
Some Joint Venture Hospitals Dominated by Foreign Investors
Total Revenue, Gross Profit and Gross Profit Margin of United Family Hospital, 2006-2009   
Growth of Hospitals, Clinics and Hospital Beds of United Family Hospital, 2008-2010
Capital Expenditure of Parkway Group Healthcare in China, 2006-2009
Total Revenue, Total Assets and Revenue Growth Rate of Parkway Group Healthcare, 2007-2009
Total Investment, Average Investment and Number of Cases in China Hospital Industry, 2006-2010
Investment in China Hospital Industry by Round, 2006-2010
Investment in China Hospital Industry by Region, 2006-2010
IPO in China Hospital Industry, 2006-2010

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