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ブラジルの医療現状 日系医師のプレゼンス、貢献 Current status of medical treatment in Brazil Presence and Contribution of Nikkeis Physicians Dr Yuji Ikuta 2017/January/23th I- General Information Brazil’s Population: 207.000.000 millions in 2016 According to IBGE- Instituto Brasileiro de Demografia e Geografia (Brazilian Institute of Geography and Statistics) Physician in activity in Brazil: 430.000 Brazilian Nikkei physician in 2009: 14.500 (Census at Centenary of Japanese Immigration in Brazil) Nowadays : approximately 18.000 About 30% of Brazil population are assisted by private heathcare service (According to IBGE- Instituto Brasileiro de Demografia e Geografia) Brazil’s physician in 10,000 per population and comparison between another countries,according WHO-World Healthcare Country Brazil 10,000 per population 17,6 Southeast’s Brazil 26 Canada 20 USA 24 Japan 21 Europe Source:ANAPH More than 33 Brazilian Healthcare System : SUS – Sistema Único de Saúde- since 1988 1 SUS - Universal Public Healthcare System Public Service ( Hospitals 21% 8% ) 1% 2 Private Service Hospital Source:FBH/April /2014 Hospitals % 2.336 30% 4.491 70% municipal state federal ANAPH The National Private Hospitals Association Hospitals of Excellence concept Nº private hospitals associated Nº beds 80 19.768 gross revenue in December/2016 22.7 Billion *All associated hospitals are recognized and have the Certificate Accreditation Source:ANAPH PRODUCTION All hospitals are level 4 classification defined by Ordinance nº 2224 of the Brazilian Ministry of Health Perform transplants – 2013 353 kidney 368 liver 23 pancreas 17 heart 430 bone marrow 92 other transplants ( cornea, bone, pancreas-kidney and lung) 90% 56% Distribution of diagnostic equipment for Public and Private Sector and type of service (2013) PUBLIC SERVICE PUBLIC SERVICE Tomography MRI CT Mammography Ultrasound Endoscopy Tomography 397 83 602 5.620 7.961 397 PRIVATE SERVICE 1.160 502 1.341 5.055 12.538 1.160 Source: prepared by ANAPH from the Ministry of Health PRIVATE SERVICE PRIVATE SERVICE 1.947 1.039 2.697 20.072 76.696 1.947 Performance Beds x Employees Hospital Nationality Nº employees Nº Beds % Nipo Brasileira de S.P Japanese 268 1.568 5,8 Oswaldo Cruz German 327 2.158 6,6 Albert Einstein Jews 652 10.631 16 British 275 3.138 11 Lebanese 368 4.823 13 Portuguese 336 3.212 9,6 Samaritano Sirio Libanes Hospital Portugues Rate of operational occupancy (%) 79,3% Average length of stay ( in days) 4,2 days IMPORT HOSPITAL EQUIPAMENTS January- September 2015 1 USA 999.349.734 2 Germany 419.962.747 3 China 336.811.234 4 Japan 153.217.667 5 Malasya 148.033.418 Per capita expediture in Health - 2014 R$3,89 /day , according CFM- Conselho Federal de Medicina INTERNATIONAL RANKING County Per capita USA 8.414 GERMANY 4819 CANADA 4351 AUSTRALIA 3866 JAPAO 3173 Chile 1606 BRASIL 970 WHO definition of Health: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Healthcare Provider ANS- Agencia Nacional de Saúde( National Health Agency) was created by the Law : 9656/98 Country Private Health Care Users/Million Brazil 1.701 54.000.000 USA 1.300 200.000.000 142 12.000.000 15 4.500.000 France Chile Private Healthcare: 54 millions users in Brazil II- Nikkei Presence Hospital Santa Cruz In 1931, the consul of Japan in Sao Paulo, Consul Iwataro Uchiyama, established the Japanese Medical Association, wich originated to the Pro-Construction Association of the Japanese Hospital. The collection campaign was promptly attended by the immigrants, who made their donations even if they themselves were in precarious economic conditions. In 1934, the construction campaign gained new momentum, with the donation of 50,000 yen from the Emperor Hiroito, symbolically on the day of his birthday, April 29. Before this gesture of the imperial house, the Japanese government decides to donate 900 thousand yen, amount divided in three annual installments. Basic building materials such as bricks and cement were shipped by Japan. Hospital Santa Cruz April 29, 1939, the Santa Cruz Hospital was inaugurated. It was a bold modern building, with five floors and a basement, with almost 10 thousand square meters of built area, with 76 rooms and 200 beds. Dr.Sentaro Takaoka The first X-ray mobile device in the city was installed in Santa Cruz - the Hospital das Clínicas had not yet existed - and the free service was provided without racial or nationality discrimination, as a sign of gratitude to the country that welcomed immigrants so well Japanese. Dr.Shizuo Hosoe Hospital Nova Atibaia In 1967 physicians Wilson Rodrigues de Freitas, Shuhatiro Wada and Yoshinori Nagaoka (in memory) opened a clinic called Clínica São Camilo in Atibaia. In June 1971, the realization of the dream came true: the inauguration of the Hospital Novo Atibaia, with the support of Armando Nieto, Prof. Flávio Pires de Camargo, Kunihiro Miyamoto, Natel Award, Murillo Macedo and Shuichiro Wada, his benefactors. The company, made up of former college colleagues and administrator Tetsuo Wada (in memory), who was part of the Society that year, achieved a rare success, always renewing itself with the admission of new professionals. Hospital Sugisawa Dr. Saburo Sugisawa, founder of the Hospital, was born in the province of Miyagi Ken and came to Brazil as a child with his family. Here, he graduated in medicine from the Federal University of Paraná and was presented with a scholarship from the Japanese government for studies at the Tokyo Cancer Institute. He founded the Sugisawa Clinic in 1987. Hospital Nipo Brasileira Enkyo: in its initial phase was focused on 2 sectors: Social Service Sector and Medical Assistance, Hygiene and Health Sector. The Medical Service headed by Dr Hosoe, Yoshinobu Takeda and Cho Kihara, after II World War Inaugurated in 1988 and considered today as one of the reference hospitals throughout the State of São Paulo, the Hospital Nipo-Brasileiro (HNB) has a modern service structure composed of 243 beds divided into apartments and infirmary, two General ICUs, Neonatal ICU And ICU Coronary, Surgical Center with six rooms, Maternity, Pediatrics and Nursery. Dr.Shizuo Hosoe Hospital Amazônia Dr.Sumio Ito Since 1966 Dr Mikihiko Ikeda Since 1967 Dr.Henrique T.Oti First Nikkei Physician in the State of Pará Great Contribution Massaki Udihara 1ª Nikkei Physician/1939 Shizuo Hosoe 1ª Japanese Physician/1940 Seigo Tsuzuki Ministry Health 1989/1990 Yukio Moriguchi Father of Geriatrics in Rio Grande do Sul Counselor of Pope Paul VI/1966-1967 Kentaro Takaoka Medical anesthesiologist, inventor of controlled artificial ventilation. JICA Activities in Health Area in Brazil Keizo Asami He organized the laboratory in 1968, in the State of Pernambuco Yukio Moriguchi Father of Geriatrics in State of Rio Grande do Sul GASTROCENTRO UNICAMP State of São Paulo Thank you