Welcome to the analyst presentations for the Q3 and the nine months of 2023, Bumrungrad Hospital Public Company Limited. Thank you very much for listening in. I am Achiraya Sritratana, Investor Relations and Sustainability. Today, the format of the presentations will be as usual, a pre-recording of the analyst presentations, which will be posted on our website, www.bumrungrad.com, under Investor Relations sections. We will follow by an analyst meeting, the live sessions, which will be held on Wednesday, 15th November, at 10 A.M., where our management will be happy to answer to your questions. If you have the questions before the meeting, you can send your questions to ir@bumrungrad.com, or you can also, during the meeting, if you have a question, you can send your questions to the chat box.
The management presenting today are Khun Neil Sorrentino, Corporate Chief Strategy Officer.
He will talk about the key takes away in the Q3 and giving the guidance into the Q4. Also, he will also update the campus master plan as usual, that we usually update it every Q3 of the year. And today we have Khun David Boucher, Chief Executive Officer at the Bumrungrad International Hospital Phuket. He will present us an update on the progress of the Phuket campus. And later, we have Khun Oraphan Buamuang, Chief Financial Officer, talk about the financial highlight and the financial performance in the Q3. And lastly, we have Dr. Niphat Gulabkhaw, Chief Operating Officer.
He will give us an update on the business update that happens during the Q3 of this year. So in this quarter, we have another excellent quarter for the year 2023, continue from the first half of the year.
In terms of the profitability, we achieved a new record high of the net profit margin at 28.8% in this Q3, and we were able to maintain a record high of the EBITDA margin at 38.9% for two consecutive quarter. Khun Neil will talk about this, talk about the margin in details later on into the presentations. I would like to highlight a couple of things for the presentations in this quarter, is that we continue to have an excellent cost control in this Q3. If you look in terms of the cost of the hospital operations, it's increased by 15.1% year-over-year, which is actually favorable change when you compare to the increase of the revenue of the hospital operations that increased by 18.5% year-over-year.
The percentage cost of the hospital operations to the operating revenue continued to decrease from the previous quarter, which helped contribute to the higher margin gain in this quarter. We continue many cost management programs, such as purchasing management and inventory management, for example. This helped contribute to a decrease in the percentage of the supply cost to the operating revenue, despite the fact that there is an inflationary situations around the world, including Thailand. If we look in terms of the SWB cost, the percentage of the SWB cost to the operating revenue continues at a low percentage as we continue our excellence, operational excellence with a prudent use of the headcounts and also the OT. So this has been contribute to the continuously low percentage of the SWB cost to the operating revenue.
In terms of the discount rate, the discount rate in the Q3 is at 11.2%, fell from 11.4% in the Q2. Please note that the discount that, on the service that we provide also include the packages that we're selling both through the online and the offline channel. So the packages attract patients coming to the hospital, help wrapping up a volume at the hospital. In addition, we bundle up the service item into a packages to become more personalized packages to, in order to serve each individual needs and demands. Lastly, I would like to remind you about our capacity plans that we mentioned in the last quarter.
The annex building, which we will be the building near the building B, we will move in our patients, women, and children center into the annex building in order to decompress the building B and serve more demand in the future. In terms of the ICU beds, we are planning to add the ICU 5 of 12 beds, which is expected to finish in the next year. Lastly, the ongoing Soi 1 project. We already finished the car park in the beginning of this year, and for an additional 59 licensed beds, we expect it to finish within the 18 months. However, upon the depending upon the approval of external party. Now, that's it for my part of the presentations. Now I would like to hand over the presentations to Kun Neil Sorrentino to talk about the key takeaways in the Q3.
Thank you for joining us for the Q3 Bumrungrad Hospital Public Company Limited presentation for all of our investor community. For Q3, I've put up for you a number of key takeaways for the quarter. I'm going to go through some of them now, then I'll swing back and cover some of the other items later, including the Q4 guidance. For the quarter, we had very, very solid and very, very purified revenue growth of 18.5%. We had very, very strong Middle East and international growth, led by Qatar, UAE, Oman, and China, in particular, was very strong for the quarter. Year- to- date, China revenue has exceeded any prior period, year- to- date through three quarters, up to THB 461 million.
We've recorded our highest EBITDA, NOPAT, and respective margins for any quarter since we've been keeping the numbers. And this time, for Q3, I'm gonna share with you actual numbers for our VitalLife Scientific Wellness Center for Q3, because they're very useful to see and very important to know that VitalLife now is contributing almost 5% of our total performance. In the quarter, we did see, and this is a seasonal thing, usually in Q3, we did see RSV, which is respiratory virus, and seasonal flu cases. There was a significant number of Thai patients who came with RSV and seasonal flu. There was very high expat revenue growth in the quarter, in particular from the United States, both U.S. nationals living in Thailand as well as those here as tourists.
It represented the highest contribution of the expat and international revenue by nationality. In the quarter, the Middle East revenue grew by 31%, and for three quarters, the Middle East revenue grew by almost 70%. It was the strongest nine-month Middle Eastern performance we've had in the history of the company. I'll come back to Q4 in just a moment. Now, let's get into the detail. I put these numbers together for you so you can see what the net revenue trending has been, and there's two points I wanna make about this slide. The first is, is that it's ascending growth, and you all know that the net revenue has been growing from 2021 through 2023.
But what's also important about this slide and the way the numbers play, is the variation of the difference between the revenue from period to period.
If you see the net revenue in 2021 as an example, it was THB 2.6 billion. But after we came out of the pandemic in 2022, it rose to THB 4.1 billion. So when you calculate revenue growth off of a lower base, that's how you wind up with 55.2%. But as we move away from that pandemic period, you will see that the higher base of net revenue is going to show a lower quarter-over-quarter increase, and Q2 Y 2022 is a good example of that. If you were to take the Q3 of 2022, it showed THB 5.6 million. The growth between THB 5.6 million in 2023 Q3 was THB 6.7 million, and that's the quarter that we're in. We're showing 18.5% growth.
If we were to take that number, the THB 6.7 billion, and match it up against the 2021 Q3 number, you'd see that the percentage growth would be huge. So these are the two points I wanna make about that. In summary, as we move farther away from the pandemic, you're going to see a percentage growth more reverting back to the mean in terms of our overall performance. Although, when you look at all of our verticals, international, expat, and Thai, and inside international, many different countries that we're in, as an example, Saudi Arabia, it's a new country. We generated THB 46 million in revenue for the quarter. As we move out farther, you're going to see less of a variation in the percentage growth because the base is higher. Next slide.
But not to confuse the changes in the base with the purity and the high revenue intensity of the numbers. When you look at 2023 for Middle Eastern, 70% growth, when you look at that number, you have to look at the revenue intensity and the resource consumption inside of it. That is what is driving, in large measure, our earnings in 2023. Price is, price is a piece, but it's a very small piece. We've only raised prices in 2023, 6.6%, and I'll talk a little bit about 2024 in just a moment, 'cause we finished our budget for 2024. We presented it to our board on last Wednesday, and I'll go over some numbers for you then. This is a series of numbers that I presented to you.
It's showing the EBITDA and the NOPAT for the three quarters. And what's interesting about this is not only the growth, but the variation and the percentage of that growth, both for EBITDA, NOPAT, and then the margins. You can see our margins are record number margins. And again, this is coming from high revenue intensity, not solely price. But two things are driving this: volume and high revenue intensity, which I translate to mean purity of the revenue. And we may have even had a bit of a dilution to it, even though Q3 was our strongest quarter of the year on earnings, and the dilution was as a result of what I mentioned earlier, flu and respiratory virus. Next slide.
Different presentation of some of the same data, except it shows year-to-date numbers, and then take the far right side of this slide. The year-to-date numbers are also very informative for the investor community. When you look at the growth for margin on EBITDA, and when you look at the EBITDA and NOPAT performance for three quarters, it's rather stunning from 9M 2022, 9 months of 2022 through three quarters of 2023, the variation is THB 5 billion, up to THB 7.2 billion on EBITDA. Very strong performance. Next slide. This shows the same information, but for net profit. Again, the comparatives are dramatic from period to period. Positively dramatic. Next slide. Now, let me move away from the performance for the quarter.
As sterling as it was, and we're very pleased with the performance, I mentioned earlier that we completed our FY 2024 budget for next year and presented it to our board, which was approved by our board. Out of that budget effort by everyone here concerned came a five-year revised campus master plan. In summary, what are we gonna be doing next year, and what are we gonna be doing over the next five years? Well, at the top of this, you'll see we're talking about new construction. The Soi 1 project, I've mentioned earlier, was in three phases. We've accelerated phase III into phase II. phase I has been completed, and that's the car park, 200-car park. phase II is budgeted to begin in 2024.
We will have a new hospital, a new 59-bed hospital, as the Part A of phase II, and the Part B of phase II will be the third building of the group. That will include a Bumrungrad Oncology Institute inside of it, as well as some other advanced technologies that we're going to put in that building. But we're gonna finish the next two buildings of the three, starting in 2024. We have announced, and David Boucher, our CEO of the campus in Phuket, is gonna talk a little bit about the Phuket Hospital project and its status, but that is inside new construction in our budget for 2024 going forward. But we've already spent money on buying the land in 2023.
For the existing campus, this is the listing of the key things we're gonna be doing inside of the building, which is the hospital. Moving to the five-year plan, for those of you that follow this closely, this total number at the end of five years has been about THB 13+ billion for the five-year period. It has moved to THB 17.8 billion, and the biggest part of that are two pieces. One, the Phuket expansion and new project there. And we have included, beginning in 2028, the Phuket, the Phetchaburi Hospital, that we've been moving out because we haven't needed the beds, but I've left it on the roadmap nonetheless, and that originally was THB 880 million, but given inflation and cost of living, that number now has ballooned to THB 9.3 billion.
But that's in the roadmap, in the budget. We're not sure if it's gonna start in 2028. We'll build it when we need it, but at least it's in the budget, so we can calculate CapEx needs for the next five years. That's our latest campus master plan and hospital construction update. One other thing about our CapEx budget for next year. Our hospital routine CapEx, including IT, will be about THB 931 million. That's about THB 250 million more than what it has been historically. We delayed, during COVID, we delayed some reconfiguration, we delayed some replacement, especially in IT, and there's that difference in monies, specifically being spent for IT, IT renovation, and IT additions, and replacements. Next slide. So now we go back to some of the detail for the quarter.
What's interesting about this slide is that for expat and international, with 67% of our total revenue, that was the highest percentage all year long. We touched 67, but not quite 66 and change. This quarter, it was 67%. And if you look at the year- to- date, nine months, it's 66%, so it was a bit higher in Q3 than the average for the nine months. Next slide. So the net patient revenue overall, as I said earlier when we first opened up here, was 18.5%. Through nine months, it's 28.1%. International was 15%. But more interestingly, through nine months, and this goes to the question about revenue intensity of very sick international patients, it was up through nine months, 41%.
Thai was up 20% for the quarter, and I referenced what that was really about. For the year, through nine months, it's 14.5, and expat, 27%. I talked about that earlier, what that was being driven by. And 17% overall. Next slide. Now, the Middle East, of that number, where I talk about international total, the Middle East, as I had said earlier, was 70.8% for the year, and for the quarter was 31%. Very high utilization of our Middle Eastern sponsors, coming to Bumrungrad, led by several countries. I'll talk what they are in a bit. Indochina was down 4.4% for the quarter quarter-over-quarter. That's principally driven by Myanmar. Myanmar is having very significant difficulties with forex depreciation, military intervention.
The political unrest there is, continues, not approving approved passports, not issuing visas. Difficult for patients to come to Thailand, difficult for patients to come to Bumrungrad. But nonetheless, we're seeing about 75%-80% of the patients we were seeing a year ago. That 20% decline is what's driving that -4.4% overall for the Indochina sleeve, and all others were 17% and 43%. Next slide. So this is the top 10, and China has made it to number 10 because we were very, very pleased with the performance of China business. That's two pieces. That's international patients coming from China, and that's expats, Chinese nationals living in Thailand.
The two combined, for the year- to- date through nine months, is THB 461 million, far exceeding what we've done through nine months of prior years. Qatar leads the way. The growth there is astounding, 85.4% for the quarter, and so forth on down. You can see Myanmar is down 9.4%. From a year ago, up 5.5, but that's. You have to take into account that you're looking at the sort of the beginnings or the endings of the pandemic there. That's why it's up 5.5%, but the number for Q3 should be higher, but because of the unrest, it's down 9.4%. United Arab Emirates was also a big contributor in the quarter, so was the United States. I mentioned that earlier.
Oman was up a significant amount. These are not revenues, these are percentages, but the totals are significant. I'll go through what those numbers are, Pierre, if for those of you that are interested. Next slide. And for the first time, I'm going to cover not only the VitalLife margins, NOPAT, and EBITDA, but I'm gonna cover for you the actual revenue and EBITDA performance and the NOPAT performance, which I've not covered before, because it's now becoming a very significant piece of our business. And this whole idea of scientific wellness, longevity, lifestyle is becoming a bigger and bigger and bigger piece of the business all over the world, and we're sharing in that. And we expect this business to grow.
To inform you, we are going to open a VitalLife Phuket, which a number of the staff are going to oversee, including David Boucher, since this is his market. We will be opening that in 1H 2024. But looking at the performance for the quarter, this piece of business generated THB 138 million, up 41%, and up almost 50% through nine months, from the prior year. For this nine-month period, 2023, generated THB 348 million. But more pleasantly than that is the margins of this business, 44%, year- to- date, 52%. And you can see the margin changes here at the EBITDA and NOPAT numbers, and you can review this when you take a more closer look at it.
But it's a very important piece of business for future growth, and we intend on expanding this business beyond even Phuket. Next slide. Please go back to the takeaways. I did not mention Oman, but that too was a major contributor in Q3, 2023. Going to finally the Q4 guidance. It's a seasonal issue with Q4, holidays, Christmas, New Year, Thanksgiving, et cetera. International tourists slow down in the last two to three weeks of every year-end of our business. I'm guiding low double-digit growth. Might be high single digits, but I'm gonna guide very low double-digit growth for Q4. We'll see where that turns out. We'll look forward to answering all your questions next week in the live stream Q&A. Please join us if you can. Thank you very much.
Sawasdee ka.
Sawasdee khrap, and good morning, everybody. Thank you for your valuable time today. Again, my name is David Boucher, and I serve as the CEO of Bumrungrad International Hospital Phuket and the Phuket market. Today, I will share with you some updated information about our first-ever greenfield project. As noted last quarter, we've acquired over 16 rai of land near the Phuket International Airport in the north of the island. We are designing a 150- to 250-bed boutique hospital, an advanced diagnostic center, and a car park of sufficient size to comfortably accommodate our patients, their visitors, our physicians, and of course, our dedicated employees. We have engaged DWP Architects and are working seven days a week with them to design this new six-star facility.
We've also engaged with Meinhardt for mechanical, electrical, plumbing, and traffic, along with several other contractors, such as laundry, linen, and food services. We are working in a focused, measured manner and have many aspects of this major project on parallel tracks. We continue to expect to open the new facility in late 2025 or early 2026. The new campus will consume between 47,000 and 50,000 square meters. As Neil mentioned earlier, we intend to open a VitalLife center, totally separate from this, in Phuket in Q1 of 2024. We also have made the decision to purchase additional property and to build a staff accommodations.
We increasingly find that the Phuket market is a compelling one for a number of reasons. Today, I will not list out all of the many encouraging reasons that I did back in the Q1 update.
However, I will share that since my family and I relocated to Phuket and are now living here full- time, we find that the reception to Bumrungrad is substantially gracious and undeniably positive. In fact, the Phuket referral office that we opened back in mid-2022, continues to increase the number of patients that we facilitate to Bumrungrad in Bangkok almost every single month. As I shared with you back in May, we fully intend to leverage existing referral relationships from many parts of the world as we expand our clinical capacity and footprint in Phuket. In addition, we are 100% confident that the 40 airlines which now service Phuket, will facilitate our international medical tourist growth at our new boutique hospital.
Let me close today by sharing that we are both excited and confident that this THB 4 billion project in Phuket, we are excited to begin construction just as soon as we have all the necessary permits in hand. Thank you again very much for your time and attention. Khop khun khrap.
Sawasdee kha. Good morning, everyone. I'm Oraphan Buamuang, Chief Financial Officer. I would like to present the financial highlight and financial performance for Q3 2023 and nine months 2023 kha. In Q3 and nine months this year, total revenue, EBITDA, and net profit amount were improved when compared to same period last year, and also above year 2019 pre-COVID situation, as shown in the first table. The improvement mainly came from the higher contribution of international segment, had a positive impact to patient volume and revenue intensity continuously in this year. In terms of profit margin, in Q3 this year, EBITDA margin, net profit margin were 38.9% and 28.8% respectively. Net profit margin is the new high record kha. Move on to see financial performance.
The consolidated revenue in Q3 this year was THB 6,775 million, increased from Q3 last year by 18%, and also above than Q3 2019 by 42.4%. The total revenue improvement mainly came from the increase in revenue from hospital operation. When compared to Q3 last year, revenue from Thai patient and non-Thai patient increased by 20.2% and 17.6%, respectively. When compared to Q3 2019, revenue from Thai patient and non-Thai patient increased by 42% and 42.3%, respectively. For nine months this year, the consolidated revenue was THB 19 billion, increased from nine months 2022 by 28%, and also above than nine months 2019 by 38.1%.
The increase in revenue mostly came from volume and revenue intensity. In terms of revenue contribution by nationality, the contribution of international in Q3 this year was 67%, which the same proportion in Q3 2022 and Q3 2019. For nine months 2023, revenue contribution from international patient raised to 66%, which pretty close to 67% in nine months 2019. In the overall, the percent contribution was coming back to year 2019 pre-COVID situation kha. In terms of revenue contribution by service, in Q3 this year, revenue contribution from inpatient service increased to 51% from 48% in the same period last year, due to IPD revenue increased by 25%, which more than OPD revenue increase at 10%.
The higher increase in IPD revenue, mostly due to higher volume and intensity of IPD case. In nine months 2023, revenue contribution from inpatient also increased to 51% from 48% in same period last year, with the same reason as already mentioned. In terms of revenue contribution by payer type, the government third party contribution in nine months this year increased to 18% from 13% in nine months last year, mostly due to revenue from government sponsor increased by 77%, which associate with Middle East patient revenue increase. In terms of insurance contribution in nine months this year increased to 18% from 16% in the same period last year, due to insurance revenue for nine months this year increased year-over-year by 43%.
Self-pay contribution in this year declined to 63% from 70% in the previous year, mostly due to the revenue from self-pay patient increased by 16%, which lower than revenue growth rate of government third party payer and insurance payer. In term of EBITDA and EBITDA margin, as a result of increase in revenue and cost containment program, EBITDA in Q3 this year was THB 2,636 million, improved from same period last year by 26.2%, and improved from Q3 2019 by 67.5%, with EBITDA margin 38.9%.
EBITDA in nine months this year was THB 7,230 million, improved from same period last year by 45.6%, and improved from nine months 2019 by 65.8%, with EBITDA margin 38%. In terms of net profit and net profit margin, net profit of Q3 this year was THB 1,954 million, which improved by 30.2% and 85.2% from Q3 last year and Q3 2019, respectively. Net profit margin of this quarter improved to 28.8% from 26.2% and 22.2% in Q3 last year and Q3 2019, respectively.
For nine months this year, net profit was THB 5,286 million, which improved by 56% and 85% from nine months 2022 and nine months 2019, respectively. Net profit margin for nine months this year improved to 27.8% from 22.8% and 24.8% in nine months 2022 and nine months 2019, respectively. In terms of leverage ratio, net debt to EBITDA of nine months 2023 was - 0.2x due to less net debt, and net debt to equity in nine months this year was also - 0.1 x due to less net debt as well.
This is our financial highlight and financial performance for Q3 2023 and nine months 2023. Thank you for your attention.
My name is Dr. Nipat. I'm a Chief Operating Officer. So today, I'd like to share you about the business and operation update. For the nine months of 2023, the performance of the center of excellence, which is including of the cardiologies, oncologies, neurologies, gastro and colorectals, and ophthalmology. For cardiologies, we focus heavily on the cardiac catheterizations, which is treatment for the heart attack and EP, electrophysiology, treatment for abnormal heart rhythm. This performance shows a very good increase from nine months last year, 29%. For oncology, which is the top revenue generation for Bumrungrad, increased 19%. For oncologies, we majorities focus on the precision medicines, personalized and multidisciplinary. Neurologies increased 31% compared to last year.
Neurology for Bumrungrad, we combine all the neurosurgery, neuroscience, and neurointerventions, which is, of course, stroke for neurointervention to remove the blood clot, and we have many, many patients. Also, the last quarter, we promoted neuro ICU, which is for the advanced and the high technologies for neuro treatment. Gastro and colorectal. For gastroenterology, increased 26%, and colorectal surgeries increased 23%. For the ophthalmology on eye, last quarter, we promote heavily on the corneal transplant, which is the high technology to enhance our brand positioning of ophthalmology department. And of course, we are bringing the artificial intelligence to help our physicians for the better treatment, precise for the diagnostic, for the best sake of our patient as well. And for the others, revenue contribution for non-COE like children's centers, OB and gyne, is increased 24% from last year.
Next ones, for the digestive disease excellence centers, we had a press conference on the October 1. For the GI, we show the advance of the whole problems of the digestive system, starting from the general GI clinic, motility clinic, which is treatment for the GERD disease, the endoscopy centers for the advanced technology, advanced techniques, TIF, TIF, pancreatic care disease. This is very rare of the patients. Of course, it's genetic clinic for GI, for the pre-screening, for the disease of the gastro clinic, IBD and microbiome. These two disease and clinics, it can treat very rare disease for the gastro problem of the patients, which is require collaboration heavily from specialists, not only from the GI doctors, but including for the genetic specialists and the wellness. Of course, we integrate with VitalLife for this type of service. Orthopedic centers.
I'm glad to share with you that we just got the full-time, very good doctor for foot and ankle. Dr. Pongporn just joined us. Because foot and ankle, there's problems occur a lot in the children who has a deformity. And of course, our big target is the Middle East, which in the past, we had a lot of the questions and the cases coming in to make this kind of disease. For orthopedics, at Bumrungrad, we focus on the comprehensive, all the body part function of the bone and movement. Not only for foot and ankle, we have spine. Spine, which is mostly caused from the degenerative diseases. We have the endoscopic spine surgery, which is very small, the keyhole, the wound at the spine, about 6 mm , fast recovery, less pain, and very good outcome.
Sports and sport science and medicine, that we have a very good doctors, who is the head of this department. Mostly patients injury from the sport, from playing tennis, golf, and degenerative functions. We have this type of excellent service of the sport medicine. Okay, next is Fast Track Pay for Bumrungrad. For those who has experience coming to Bumrungrad, one thing that can enhance your digital patient experience is, you just download our applications. And if you want to leave earlier or want to shortcut the payment, just lock your credit card, and then you can leave the hospital without waiting for a queue.
That's going to be very good for a patient who has very time efficient. Try this. It will make your life easier. Next one, for Bumrungrad Health Villa Retreat. This is a luxurious villa for patients who boring of the hospital environment.
It's located next to the Chao Phraya River in Bang Krachao. We collaborate with the RAKxa. You will get six-star service and including medical attention. We have physiotherapy, rehabilitation, as well as you can still under care of our physicians. So, we opened it last quarter, and we got very good feedback from patients, yeah, who doesn't want to stay in the hospital. As you know, in hospital, there's a lot of limitations. You cannot do things, but here, you enjoy the luxury villas, stay in the riversides, yet get the medical care according to your conditions. And I think that's all for the recent operation update from me. Thank you.
Now we come to the end of the presentations. Thank you very much again for your time listening to our webcast. As mentioned before, we will have the live Q&A sessions on Wednesday, 15 November at 10 A.M., where our management will be happy to answer to any of your questions. For today, I would like to end the presentations here, and see you again in the next presentations in February.