Myanmar Preparatory Survey for Yangon Private Hospital Project (PPP Infrastructure Project) In Republic of the Union of Myanmar Final Report （Public Version） February 2019 Japan International Cooperation Agency Ishii-Kai Medical Corporation OS Chiyoda Corporation JR(P) 19-020 Preparatory Survey for Yangon Private Hospital Project Ishii Hospital, Chiyoda Corporation Preparatory Survey for Yangon Private Hospital Project Republic of the Union of Myanmar Final Report Contents 2. Tables .............................................................................................................................................. 7 3. Figures ........................................................................................................................................... 10 1. Background and Purpose of this Research .................................................................................... 13 1.1. About This Work ................................................................................................................... 13 1.2. Background of this Work ...................................................................................................... 13 1.3. The Purpose of this Work ...................................................................................................... 13 1.4. The Methodology of this Work ............................................................................................. 13 2. A Study of the Medical Markets in Myanmar ............................................................................... 14 2.1. Macro Environment in Myanmar .......................................................................................... 14 2.2. Medical Expenditure in Myanmar ......................................................................................... 20 2.2.1. Medical Expenditure Overview ..................................................................................... 20 2.2.2. Finance of Healthcare Expenditure ............................................................................... 22 2.2.3. Myanmar Government Policy ....................................................................................... 23 2.2.4. International Support Overview .................................................................................... 24 2.3. Condition of People’s Health in Myanmar ............................................................................ 26 2.4. Status of Development of Medical Institutions ..................................................................... 29 2.4.1. Sufficiency and Local Condition for Doctors................................................................ 29 2.4.2. Categorization, Availability, and Characteristics of Local Hospitals ............................ 33 2.5. Outflow of Patients Overseas ................................................................................................ 37 2.6. Summary of Healthcare Environment in Myanmar .............................................................. 39 3. Demand Forecast ........................................................................................................................... 40 3.1. Concept of Demand Forecast ................................................................................................ 40 3.2. Demand Segment Definition ................................................................................................. 41 3.2.1. Outline of Methods for Defining Demand Segment ..................................................... 41 3.2.2. Clinical Departments (dealt with by this project) .......................................................... 41 3.2.3. Target Customers .......................................................................................................... 41 3.2.4. Customer Segment (i): Local Market ............................................................................ 42 3.2.5. Customer Segment (ii): Outbound Market .................................................................... 43 3.2.6. Customer Segment (iii): Foreigners Market .................................................................. 44 1 Preparatory Survey for Yangon Private Hospital Project Ishii Hospital, Chiyoda Corporation 3.3. Demand Study of Target Markets ......................................................................................... 45 3.3.1. Study Method and Evaluation ....................................................................................... 45 3.4. Evaluation for proposed project sites .................................................................................... 47 3.5. Summary (Demand Forecast) ................................................................................................ 51 4. Competitive Hospital Benchmark ................................................................................................. 52 4.1. Overview of Major Hospitals in Yangon .............................................................................. 52 4.1.1. Asia Royal Hospital ....................................................................................................... 52 4.1.2. Victoria Hospital ........................................................................................................... 59 4.1.3. Pun Hlaing Hospital ...................................................................................................... 65 4.1.4. New Competitive Hospitals in Yangon ......................................................................... 72 4.1.5. Patient Evaluations for Yangon's Main Hospitals ......................................................... 81 4.1.6. Analysis of Major Hospitals in Yangon ........................................................................ 82 4.2. Overview of Competitive Overseas Hospitals ...................................................................... 87 4.2.1. Bangkok Hospital .......................................................................................................... 87 4.2.2. Bumrungrad Hospital .................................................................................................... 91 4.2.3. Samitivej Hospital ......................................................................................................... 95 4.2.4. Raffles Hospital / Mount Elizabeth ............................................................................... 99 4.2.5. Patient Evaluations for Overseas Competitive Hospitals ............................................ 106 4.3. Operation Comparison of Competitive Hospitals ............................................................... 107 4.3.1. Comparison of Unit Cost for Medical Examinations .................................................. 107 4.3.2. Non-medical Operation Support.................................................................................. 108 4.3.3. Major Suppliers ........................................................................................................... 109 4.4. Summary (Competitive Hospital Benchmark) .................................................................... 116 5. Design and Integration of Hospital Buildings ............................................................................. 117 5.1. Prerequisites Summary of Plans for Land and Structures ................................................... 117 5.2. Geological and Measurement Survey .................................................................................. 119 5.2.1. Geological Survey ....................................................................................................... 119 5.2.2. Measurement Survey ................................................................................................... 122 5.3. Infrastructure Condition Survey .......................................................................................... 123 5.3.1. Electricity .................................................................................................................... 123 5.3.2. Water Supply ............................................................................................................... 123 5.3.3. Sewage and Drainage .................................................................................................. 124 5.3.4. Gas ............................................................................................................................... 125 2 Preparatory Survey for Yangon Private Hospital Project Ishii Hospital, Chiyoda Corporation 5.3.5. Information Communication ....................................................................................... 125 5.3.6. Infrastructure Survey Summary .................................................................................. 125 5.4. Basic Building Design & Architectural Perspective ........................................................... 126 5.4.1. Planned Layout ............................................................................................................ 126 5.4.2. Architectural Planning ................................................................................................. 126 5.5. Summary (Design Related) ................................................................................................. 128 6. Investigation of Legal Considerations ......................................................................................... 129 6.1. Permissions and Regulations on Medical Institutions ........................................................