Welcome to the Second Quarter 2022 Analyst Presentation for Bumrungrad Hospital Public Company Limited. Thank you for listening in. We had an excellent second quarter, and I'd like to give you a bit of color as to what drove that performance and what we can expect going forward given what we've seen so far. We can clearly see there was very strong performance on the international business side, and the key markets were performing very, very solidly including Myanmar, Bangladesh, Kuwait, and the UAE, our core markets. In addition to this, if you compare it with 2019 levels, which you can see in the graph there, you can immediately notice that we exceeded our 2019 or pre-COVID levels. This is a testament to how strong the quarter was and how rapid the business recovery was as well.
If I recall in our internal discussions, we had expected a timeframe that was a little longer dated than what we have achieved thus far. This is excellent news for us. If you also recall, in Q2 of 2019, there was a one-off charge for provision for long-term employee benefits. It really, if you were to exclude that charge, we still exceeded the net profit levels for even that quarter. That also once again indicates to you how strong the quarter was. Comparing the Thai, the expat, the international business to 2019 levels, we actually exceeded across all three segments. For the Thai side, we were 27% above 2019 levels. We were 41% above on the expat side, 2019 levels, and we were even 1% above on the international side, the 2019 levels.
In addition to the volume growth, there was also a case mix uplift. Revenue intensity on average increased due to strong growth among the more profitable specialties within the hospital. That included cardiology, digestive diseases, general surgery, and neurology. Even checkup, which typically is a low margin or even a loss leader for us, benefited from lower discount rates. If you recall last year, we sold buy one get one free packages, which have a higher discount than what we sold at the current health fair, where we only offered a 30% discount. This reduction in discount benefited the margin as well to the benefit of the hospital.
Moreover, although COVID-related revenue amounted to 5% of total revenue, it was still lower than in relative terms compared to the previous quarter, despite the fact that there was a QoQ and year-on-year jump of 9% and 17% respectively. In addition to this, we benefited from a lower contribution of vaccination revenue in the mix, which is, if you recall in the previous quarter, rather margin diluted for us. Overall, that benefited us as well. Prudent cost management was a key factor in determining how strong our growth was as well for the quarter. In fact, if you take a look at medicines and supply costs as a percentage of revenue in relative terms, it fell by 140 basis points and 260 basis points in year-on-year and QoQ terms.
That is a very strong uplift in margins. In particular, a benefit of this is in driving up the revenue intensity margin of our business as well. If you recall in the previous few quarters that we talked about, cost management was a key aspect of what we were focusing on during the COVID years, and this really has provided that benefit relatively long term as well. This is what you see right now. On the S&WB costs, although it grew at a lower rate, it grew at a lower rate in year-on-year terms, because of the economies of scale we highlighted to you in the previous quarter, as well as good FTE and contract management. In QoQ terms, there was a reduction in S&WB because we paid off a one-off loyalty award to staff in the first quarter of 2022.
That's a one-off, which will balance out heading towards the latter part of the year. Looking forward, we continue to see sustained high volumes of inquiries and appointment requests, which are a compelling forward indicator of the business strength in the second half of this year. Internally, we in fact revised upwards our daily census targets for inpatients, having nearly reached our target for the Middle Eastern segment, which is typically much higher margin, much more revenue intense. Again, a positive outlook currently. The continued discount reduction and the international business expansion that we expect in the second half, as well as among not only the core markets that we talked about, but even the lesser developed markets that we haven't touched upon, namely markets such as Vietnam or Oman or even Saudi Arabia, are expected to benefit performance going forward.
Although there might be some offset with higher S&WB expenses due to inflationary adjustments, and higher recruitment of additional headcount of staff, we do expect a positive outlook in terms of overall business performance going forward as well. On the discount rate development, we talked in the previous quarter about the expectation of it coming down. It in fact has come down from 13.7% to 13%. That was the continued discontinuation of the loyalty program and the steeply discounted birth delivery packages that we provided last year. The reduction, although relatively slower than what it was in the first quarter, was mainly due to the fact that we had the health fair in the second quarter, which sold although less discounted packages, did slow down the rate of reduction.
This effect is expected to taper, and we do expect the discount rate to continue to fall in the second half of 2022. We haven't touched upon new patient growth and patient retention, and I want to show to you this graph which indicates to you the strength of the quarter and the performance that we have done so far. This is really a testament to the good planning and good management and foresight that we have enacted over the COVID years and really are reaping the fruits of that now. If you take a look at the top chart there, you can see for new HN, it comprised of 31% of our overall patient episodes for the first half of 2022. You compare that with a significant growth in the second half.
Sorry, in the first half of 2021 and even the first half of 2019, it looks very favorable, especially when you factor in the overall number of patients also increased. Meaning that not only did we grow new patients, we also had effective patient retention, which allowed us to benefit from the strong performance that we were talking about in the previous slides. If you look at by segment, you can see across the board very strong growth in the Thai, the ex-pat, and the international market as well, and that really is rather broad-based. We do expect to continue to perform in a strong way going forward as well.
Now I'd like to hand the presentation over to Aniello Sorrentino, our Chief Global Strategist, who will talk further about developments of the quarter, diving specifically into the performance of the individual markets and the company as a whole. Thank you.
Sawatdee krub! I too welcome you to Bumrungrad Hospital Public Company Limited, Q2 and 1H 2022 analyst presentation. You're going to hear a lot of comments during this analyst presentation from a number of people about the specifics to the spectacular quarter that we had, and in fact, it was dramatically spectacular by any measure, especially when you consider that we came from Q3- Q4 2021 at 33% revenue growth delta, and then from Q4 to Q1, there was an additional five plus percent increase in revenue, and then in Q2, we showed a 19.5% increase in revenue growth over Q1 2022. This I would remark that this was done without any price increases whatsoever.
It goes to the question of why is it that we're having these kinds of dramatic returns and performance for this company. In the quarter, I and Artirat Charukitpipat, our hospital CEO, and Daniel Kastner sat for an interview with the Bangkok Post, which was published in the Bangkok Post in quarter two. In that interview, I spoke at some length about the customer experience. I spoke at great length about the value proposition as to why people select Bumrungrad. A lot of those things I spoke about had to do with the performance of Q2. If you take a look at what I put together for you in the way of quarter two takeaways, I talk about durable competitive advantage and pricing power. What are they?
What does it mean by that when I talk about that with respect to Bumrungrad Hospital? Durable competitive advantage, that means to say that when customers, clients, patients make a choosing about where they seek their healthcare, there's a sustainability about why they make these selections. Why is it that the country has opened up so dramatically and we have jumped our performance so dramatically in kind when it was clear that during the pandemic, there was a lot of questions about whether or not the international business would return? Well, it returned with a vengeance to the benefit of our institution, and we had that confidence that it would. The reason was, is that this institution, 42 years young and 42 years old, has this kind of market power, has this kind of brand image and this kind of brand equity.
When I speak about pricing power, I am not talking about, and I will say again, I'm not talking about raising prices. I'm talking about customers, patients, clients who look at Bumrungrad and say, "Am I getting value for my money? Is the pricing power of this organization something I'm willing to pay to go to Bumrungrad amongst all others in Bangkok?" Clearly, when you look at Q4, Q1, Q2 of 2022, our customers made that decision in saying, "You know what? That value proposition is there for us. We want to go back there." When I go through the numbers for Q2, you will see some very specific and dramatic returns from various elements around the world supporting Bumrungrad Hospital. These are countries and these are patients that have been here before, many returning again for that value proposition that they see as important. Next slide. We track...
As a company, we track customer loyalty. While many, many companies do this, it's an imperfect science. Many, many companies do this, but as they do this, they're looking to get feedback from their clients to continue to deliver that value proposition I've referred to. If you look at this slide, and you can look at it at your leisure, you will see there are three main characteristics we look at: overall patient satisfaction. Would the customer, would the client, would the patient return to Bumrungrad in the future based upon their experience? How likely is it that they would recommend this institution to their family and friends?
When you look at the tracking of the data that we're getting from our patients, it validates what I talked about in The Bangkok Post interview, which is the value proposition that is Bumrungrad is unique in Thailand, and if not in Thailand, in Southeast Asia. It's the reason why we've had such fundamental increases in our business returns for Q1 and Q2 now. If you look at 1H in comparison to 1H 2021, and I'll go through that with you, that detail for a moment, you'll see the dramatic increase. It didn't have to be that way simply because the pandemic ended. It's that way because people want to come to this institution. Next slide. Digging deep now into the numbers.
I've shown you this over the last several quarters, and it's still a very, very revealing slide presentation, and it shows you the jump in revenue, EBITDA, and NOPAT. Take a look at 4Q 2021, 1Q 2022, 2Q 2022. It's what I've been talking about, and it's what others will be talking about when they talk about Bumrungrad Hospital. Our Dr. Narinthorn, who's our Chief Operating Officer for VitalLife Corporation, will be talking about his performance in his business unit, making a contribution to this. VitalLife, as an example, we've been quiet about it because it really has been a company 22 years in its duration and continues to grow. It wasn't that long ago that VitalLife was about 4% of our total consolidated earnings for the company. Now it's about 5.5%, with the base growing.
He will talk a little bit about that in detail in the next presentation. Have a look at Q1 versus Q2. THB 4.1 billion versus THB 4.954 billion in growth in total revenue. EBITDA, very, very strong growth. Net profit. Not only the net profit grew, but the margins associated with EBITDA and net profit were quite dramatic for the quarter. I would add further that as we look into 2H, which we're now in the middle of, absent some kind of an uncontrollable circumstance, we are seeing tremendous demand from around the world for our products and services, for our company. I won't predict whether or not these kind of performances will replicate themselves in Q3 and Q4, but I'm very positively optimistic about where we go in 2H.
I'll talk a little bit more about guidance in a moment. Next slide. This slide is quite revealing for you because it shows a very interesting trend. As you look at the brown area, which is international, and go back to 1Q 2021 from 25% grew to 49%, almost double the revenue from 1Q 2021 to 2Q 2022. In the same way, we add these two numbers up, 49 and 13. That represents 62% something of total international business, which includes expat as well as all other international business. That's important for us as a marker. It tells us that we are fast approaching our record high of revenue of 66% of international business against the total revenue. That didn't happen until 2015 and then again 2019.
Correspondingly, if you look at the blue segments, you will see that is the Thai business. It has gone from 54% down to 38% by revenue. A lot of this was intentionally manufactured by our company as a result of in the early days, meaning 1Q 2021, when the pandemic was around, we were trying to incentivize locals because that's all that would come to any hospital in Thailand, including ours. We were trying to incentivize them to come and use services here at Bumrungrad. We provided a lot of promotional opportunities for them, and you can see that it worked. When Daniel speaks to you later about our percentage of discounts in these days, 1Q 2021, 2Q 2021, our discounted rate was pushing 16%-17%.
It is now, I think for the quarter 13, a little pinch over 13%. Dropped 4% points on that base of revenue. It's fairly dramatic. This is the orientation that I like to see from a strategic standpoint as we continue to build this platform of this company internationally. Next slide. For the segments, the market segments themselves, I mentioned earlier that the revenue grew almost 20% quarter-on-quarter. If you think about 5%+ before that if you think about 33% before that quarter, meaning Q4 over Q3, you can understand, well, what is driving this in terms of marginal contribution? The answer is very, very clear. What's driving it is our international business. I've just shown you how it has changed over the quarters.
When I look at profitability by markets, I won't go into which markets have the higher profitability or not because that's proprietary information. It's fairly self-evident when you look at the volume changes in our international business, that international is driving not only high revenue intensity. We go back now to my earlier point with respect to pricing power, where patients continue to come here from all over the world when there are assets in those countries that they could go to. They choose this asset to the extent that you've seen this change in performance. Obviously, year-over-year, the numbers are really not relevant because one is during the pandemic and 2022 is absent the pandemic for the most part. That's the net patient revenue overall. Very strong quarter. Next slide. On the Thai business, it grew slightly.
We weren't displeased with the growth in the quarter. Look down here, though, where you look at the quarterly revenue trend. This green line here, you'll see the variation this slope difference right here, Q1, Q2, that's 2022. You'll see that it's higher in terms of overall revenue. What drove that overall revenue growth with not very, very much volume growth was revenue intensity. Meaning, as Thai people came to this hospital, they were sicker in the quarter. Their resource consumption was higher. This is what drove this revenue trend. Not so much volume, more resource consumption. Of course, year-over-year, not relevant. Next slide. The same story for expat. You'll see that it grew slightly, up 1% to 0.8%. What did grow was the revenue change. This slope line here changed.
Same story with expats as well as Thai patients, and that related to revenue intensity, meaning sicker patients coming to Bumrungrad during the quarter. Next slide. Now we get to the meat of the quarter. This is where there's a lot of meat on the bone about what happened in the quarter. I much rather prefer to have explained to you why rather than just show you these numbers. The numbers are self-evident. In the quarter, you see that the change was almost 48% all international. So mind you, that's expat, which are foreign nationals. They're considered international, as well as Middle Eastern, Indochina, etc. That number grew almost 48%. This slope line here, this rising slope line, Q1 over Q2, you can see how dramatic it was. Next slide.
Here are the international countries that grew by percentage, and I'll take a few moments to tell you the delta, revenue changes for these countries without getting into, the gross revenues by country. You can see the top five countries that drove, a high increase quarter-over-quarter, led by Myanmar and our Indochina country sleeve, followed by Kuwait, Qatar, Cambodia, and Bangladesh. Interestingly, over the last two and a half quarters, we spent a lot of time with our sponsors and partners in the UAE, and that business has dramatically grown, for us at Bumrungrad. This is a market that used to be ours before the pandemic. Then the pandemic came, and a lot of these patients were rotated to places like Turkey, places like India.
We spent good time with our relationship partners in country. I'll show you some data in a moment that describes how this particular market Number 6, UAE, has grown so dramatically for us. Next slide. Specifically for the Middle East, the quarter-over-quarter revenue change was 34%. For the year-over-year number was, you know, significantly higher, but again, not relevant. This was a big part of what happened in the quarter. Not the total part, but a big part. Next slide. Indochina was the market sleeve that grew the most by percentage, 65.7%, led by Myanmar. Myanmar was our top country in many different categories, not just in revenue, not just in volume, not just in patients, but many other key markers.
Even though there's still unrest in this market, patients are willing to get on airplanes and come to Bumrungrad. I can tell you, by the way, there's lots of hospitals in Myanmar, lots of hospitals in Yangon, lots of doctors there. This is why Myanmar is the best example of why these patients come to this institution. Next slide. We get into the EBITDA flow and the NOPAT flow for the quarter. Spectacular growth on EBITDA quarter-over-quarter of almost 46%. Next slide. The margin, even more spectacular is the change when you look from 1Q 2021- 2Q 2022. It jumped to 34.4%. This is a combination...
Now, again, for those of you that are not as familiar with our company as some others of you are who are listening, this is a combination of both volume, complexity of care, and revenue intensity. The other thing that happened in the quarter, which I haven't remarked about, but I will now, is our cost control. For the second quarter in a row, the cost control has been excellent. I have to compliment our team at Bumrungrad Hospital, our team at VitalLife. They've done a very good job of managing the costs. As we transition from a pandemic situation to a very, very live, huge volume change, they were able to take that volume change on, maintain the customer satisfaction, the value proposition I talked about, and deliver these kinds of performances.
This is the trend line of the EBITDA margin, more than double from 1Q 2021. Next slide on margin for NOPAT. Because of the combination of things I just mentioned to you, the net operating profit after tax QoQ, you would expect if you're managing costs effectively, that this percentage growth would be much higher than your EBITDA growth. In fact, it was. It was up almost by 15 points against the prior number. Next slide. This trend line I'm presenting to you so you can see, something very nominal in 1Q 2021 or 3.4% during the height of the pandemic to 23.5%. We're close to and are reaching our record margins both for EBITDA and NOPAT.
I expect to achieve that in 2H, all things under control. Next slide. Now, as I referenced, Dr. Narinthorn is gonna talk in detail about what's driving VitalLife performance. It's really been the business of what I would reference as a quiet storm. 22-year-old business that has just been spectacular for us, both on volume and on margin. You can see the revenue growth for Q1 versus Q2. You can see the year-over-year growth of 105.5%. It's running now somewhere around THB 30 million-THB 30 million plus per month on EBITDA. It wasn't that long ago that it was half that number. We have, of course, and he will speak about our satellite VitalLife, a Scientific Wellness Center at RAKxa.
We will be talking about expanding the scalability of this asset going forward in 2H. We'll be reporting some positive news about that in the upcoming quarters. Please go back to the takeaway slide. Oh, I promised you that I'd give you some growth information. Let me do that. Go back to the slide with the listing of the international markets, please. Myanmar, etc. Yes, this slide. So these are the percentages that I talked that I showed you earlier, and we didn't show you this slide. But for the quarter, not only did the business grow 76.5% on a percentage basis, the Myanmar revenue grew THB 196 million quarter-over-quarter. Qatar grew 82 million baht. Cambodia grew THB 135 million quarter-over-quarter.
This is the delta I'm giving you. I haven't given you the base, but this is the delta. The United Arab Emirates grew THB 89.3 million quarter- over-q uarter. We're particularly proud of this market 'cause it was moving along okay, but it dramatically showed up in Q1 and especially Q2. The US market, which is mostly expats here, grew almost by THB 20 million. China grew THB 39 million. On the question of China, we haven't been really soliciting any of this business because it hasn't been available to solicit. The country has been closed. Just this past week, if you follow this like we do closely, Beijing has increased by 200% the number of outbound flights outside of China.
What we're learning is that initially there are more business executives leaving China to continue their business outbound. We're expecting the fourth quarter as we talk to our agents, et cetera. We're expecting the end of the third quarter, the beginning of the fourth quarter or so, more Chinese residential tourists coming to Thailand. Before the pandemic, it was almost THB 10 million Chinese who came to Thailand 'cause they love coming here. Our revenue growth was very nice before the pandemic. We expect to enjoy a similar return of Chinese patients to Bumrungrad Hospital in Q4. Please go back to the takeaway slide. In the quarter, our Board of Directors approved an interim dividend to our shareholders of THB 1.15, which represented 48% of EPS for 1H.
If I take you back a year ago, the absolute same amount of Thai baht that was distributed, THB 1.15, as well as the absolute amount of Thai baht itself, equated to almost 300% of EPS, which shows you the change in the earnings growth year-over-year. The board, looking at historical trends, continued to reward their shareholders. In addition to which, we, the management of the institution, also rewarded our employees in 1H with a number of financial incentives and loyalty awards, as well as increases in base salary in 1H, sharing the benefits of the 1H performance with all BH PCL employees. Nonetheless, our cash and cash equivalent balances is almost THB 7 billion. This is before the payment of the interim dividend payout.
We begin, at the end of August, our forecasting for 2023. We have a number of brand-new markets that we're going to be targeting for 2023, for which we'll do a lot of work at the end of 2022 about. We'll spend more time. I'll spend more time talking to you about those new markets. These are brandnew markets that we now have ability to penetrate with a different level of management that I've put together. I'll talk more about that in our November analyst presentation. Insofar as guidance is concerned for Q3. Can I project the same kind of 20% revenue growth? No one can, and I wouldn't want to. I wouldn't wanna try to do that.
What we do see is sustained demand for this value proposition called Bumrungrad. We're gonna keep delivering the experience that we know how so well to do, for as long as these patients continue to come here. We expect that to continue for some time. We at the end of this week will be putting on a live stream Q&A. I believe that's going to be Thursday or Friday. Is it Friday? Friday, correct. Friday at 10:00 A.M., please join us. Ask any questions you may have. You can submit the questions in advance or during the live stream. Thank you for joining us.
Good morning, everyone. I'm Jittima Nuntavichithaporn, Deputy CFO . I'm pleased to report the financial highlight and the financial performance of the second quarter and the first half of 2022. For the financial highlight of the second quarter 2022, performance was improved from the second quarter of last year and the first quarter of this year. This was primarily due to a significant growth in international business. For the second quarter 2022, revenue increased by 64% year-on-year. This was mostly due to an increase in revenue from non-Thai patient by 120.8%, and Thai patient by 15.8%. EBITDA increased by 196.1% with the EBITDA margin of 34.4%, increased from 19.1% in the second quarter of the previous year.
Net profit and diluted earnings per share increased significantly by 438.6% with the net profit margin of 23.5%, compared to 72% in the second quarter of 2021. Comparing with the previous quarter, the second quarter 2022 revenue increased by 19.3%, mostly due to an increase in revenue from non-Thai patient. EBITDA increased by 45.8% and net profit grow by 60.8%. Comparing with the second quarter of 2019, in order to see the performance of the current quarter to the pre-COVID levels. The revenue increased by 15% from the second quarter of 2019. EBITDA increased by 46.2%, and the net profit grow by 60.8%. For the first half of 2022, revenue increased by 59.9% from the previous year.
This was primarily due to an increase in revenue from non-Thai patients. EBITDA increased by 191.5% with the EBITDA margin of 31.6%, compared to 17.3% in the first half of last year. Net profit increased by 514.8% with the net profit margin at 20.8% in the first half of 2022, compared to 5.4% in the first half of 2021. Compare with the first half of 2019 pre-COVID level. First half 2022 total revenue increased by 1.1% and net profit increased by 4.7%. Net profit margin rose to 20.8% compared to 20.1% in the first half of 2019. Move on to the financial performance.
The company reported total revenue in second quarter of 2022 of THB 4,954 million. This amount represent a 54% increase from the second quarter of last year, and 15% increase from the second quarter of 2019. For the first half of 2022, total revenue was THB 9,106 million. 59.9% increase compared to the first half of last year, and 1.1% increase compared to the first half of 2019. Revenue contribution by nationality. The percentage of revenue from international patient increased to 62% for the second quarter of 2022, compared to forty-six percent in the second quarter of 2021, and 66% in the second quarter of 2019.
For the first half of 2022, percentage of revenue from international patient increased to 68% compared to 46% in the first half of 2021, and 59% in the first half of 2019. Revenue contribution by services. For the second quarter of 2020, the proportion of revenue from inpatient services and outpatient services was at 46% and 54%, almost the same as pre-COVID uncertain levels. Second quarter of 2019 was 45% and 55%, while the second quarter of 2021 was at 54%, 46%. For the first half of 2022, the proportion of revenue from inpatient services and outpatient services was at 46% and 54%. Almost the same as pre-COVID level, first half 2019 at 46% and 54%, while the first half of 2021 was at 53% and 47%. Revenue contribution by payer type.
Self-pay increased from 64%- 71% in the first half of this year, mostly due to an increase in international self-pay. Insurance contribution decreased from 22% to 17% in the first half of 2022, mostly due to a decrease in expat insurance business. The government third-party payer contribution was slightly reduced from 12% last year to 11% for the first half of this year. EBITDA was at THB 1,706 million in the second quarter of 2022, increased by 196.1% from THB 576 million in the second quarter of last year, and increased by 46.2% in the second quarter of 2019. We are so proud to say that this quarter EBITDA amount is our new high record.
The increase in EBITDA was mostly due to an increase in revenue and also our continued cost management programs. The EBITDA for the first half of 2022 was at THB 2,876 million, a 191% increase from the previous year, and 3.2% increase from THB 2,788 million in the first half of 2019. EBITDA margin was 34.4% in the second quarter of 2022, increased from 19.1% in second quarter of last year, and increased from 27.1% in second quarter of 2019. EBITDA margin was 31.6% in first half of this year, increased from 17.3% from first half of last year and 30.9% in the first half of 2019.
Net profit for the second quarter 2022 was at THB 1,166 million, increased by THB 438.6 million from THB 216 million in the second quarter of the previous year, and increased by 60.8% from THB 725 million in the second quarter of 2019. Net profit for the first half of 2022 was at THB 1,891 million, increased by 514.8% in the first half of 2021, and increased by 4.7% from THB 1,806 million in the first half of 2019.
Net profit margin was at 23.5% compared to 7.2% in the second half of last year, and compared to 16.8% in the second half of 2019. For the first half of 2020, net profit margin was at 20.8% compared to 5.4% in the first half of last year, and 20.1% in the first half of 2019. Net debt to EBITDA was at -0.3 for the first half of 2022 compared to -0.6 in 2021. This is mostly due to the higher EBITDA. Net debt to equity was at -0.1 times as of June 2022, the same as December 2021. Thank you, Kap.
Good morning, everyone. Today, I would like to present the hospital operations in second quarter this year. As everyone knows that Bumrungrad always focus on patient safety and quality, we are very proudly to present our achievement in JCI CCPC, or Clinical Care Program Certification in Heart Failure Programs. This program is very important and to be the gateway for heart transplantation, which right now we have successfully done for three cases, and now, case Number 4 and Number 5 waiting in our, queue. Moreover, we just passed the second re-accreditation program from the College of American Pathologists to certify our best practice in laboratory services. Next, we continue seeking for the new advanced technology to support our Doctors and Healthcare professional in order to deliver the best clinical outcomes to our patients.
We just launched a press conference in the new artificial intelligence for Radiology, in which we use this AI to read and interpret the chest film, X-ray and Mammograms. It works as a decision support tool to improve the accuracy and also reduce the turnaround time to only five minutes per patient. I think everyone knows about this technique we call water vapor therapy. In fourth quarter last year, approximately around nine months ago, we have introduced a new innovative minimally invasive therapy which is designed to treat enlarged prostate. We got overwhelmed with interest from patients and positive feedback from our patients. Lately, we are the first center in Thailand and also in Asia to be certified by Boston Scientific.
The criteria based on the reviews of our clinical outcomes are around 85%-90% success rate from over 100 patients in the past nine months. This is the performance of our Bumrungrad Health Network. We expand our MOU partnership from 73 hospitals in the first quarter to be 77 hospitals in second quarter. The four hospitals are already in the presentation. If you see the graph on the right-hand side, the referral revenue is slightly dropped around 7%. I think because of right now our MOU hospitals are overwhelmed by the COVID patients, so they have less referral patients to us. Next. Everyone waiting for our health fair campaign. This year we arranged in-house health fair event for both offline and online channels to serve our customers.
From the slide you can see that over 2,000 packages sold with approximately THB 51 million. In which this channel we can acquire new patients as same as the previous year and can get the downstream revenue from our checkup center. This is the performance from the digital market. The revenue from online store increased around 160%, approximately nearly THB 240 million. We sold around 15,000 packages via online, mainly from the COVID vaccine Moderna and gift vouchers. In average, per customer, they bought our package 1.95 package per person. Numbers of the customer purchasing via online right now is higher than 200% compared to previous year.
For Bumrungrad application, right now active user that use our application is around 2,500 users per day. This is the new look of Ward Six after we renovation this ward. This is our maternity ward. We have to design the new operational workflow and also make the environment look very warm and homey and feel relaxing for mom and baby. It's very beautiful. Right now we start renovate Ward Seven. This is the new location of the Bumrungrad Airport Representative office at Suvarnabhumi Airport. We relocate from door 10 to door 9. In which we would like to have our office more visibility to the customers. This office serve fly-in patients since the beginning of May.
For the better convenience after long flight, we service our customer by providing the staff to help facilitating hotel reservation, doctor appointment and also the transportation from the airport to Bumrungrad Hospital. This is to ensure that all the journey of patients after they arrive the airport in Bangkok, and they can better comfortable and convenient to come to use our service at Bumrungrad Hospital. Today is for me end. Thank you.
Today I would like to update about the VitalLife performance for the first half of this year. This year our performance both in VitalLife and RAKxa is increased significantly. Now we see the visit year-to-date in June is increased 50% year-on-year. We can see the comeback of the international market is increased about 421%. We still keep our Thai market and expat market the same. The reason that we have an increase of international market a lot because even during COVID-19, during these two year, we still keep in touch with our RO, our patients. We still continue to send our supplement to the patients in Middle East, in CLMV.
When the country open, they come back. Not only our existing patients, we have a lot of new patient, especially for the international market. The RAKxa see the good trend in the first and second quarter this year. We see the increase of number of membership in RAKxa from 118 last year to 140 this year. We see a lot of Thai patient, Thai guests who come to visit at RAKxa. We start to see the good trend that international market start to come to RAKxa. Another key success this year for RAKxa is we start to have the case that have paid by embassy of Arabic.
This is a good trend that in the future we can have more and more cases from Middle East. Both self-pay and they have a payer. To see the top visit growth by nationality. Number 1 is still Thai. During COVID-19 this two years, we increase Thai visits from 7,000 visits per year in 2019 to 14,000 visits last year. It's double in two years. The growth in this is because of awareness in the health consciousness from COVID-19. Our branding, our marketing communications, and we also recruit a new doctor to join VitalLife and bring new technology, bring new treatment and supplements. Number 2 is United States. Bangladesh, this is very good trend too.
764%. Myanmar, we still keep in touch with Myanmar and we visit Myanmar Yangon clinic of Bumrungrad, and we try to collaborate and have program together. UAE, Qatar, Kuwait, this is our key market that we want to focus. Cambodia and China. We have plan to go out more and second half of this year to visit this key market. We increase our intensity to not only increase visit. Our intensity, we increase it by bring the concept of wellness tree. You can see some wellness center, they focus only give the supplement and vitamin. With holistic approach with by VitalLife, we focus from genetic. Genetic is one of the key of Bumrungrad Hospital.
We try to bring genetic to integrate with wellness and create a wellness plan for our patients. We combine lifestyle factor, and we try to combine detoxification program for our patients. We still focus on hormone on immunity. We try to add more function that we try to help to improve quality of life by improve the gut health, energy in the cellular level, brain health, sexual health, detoxification program, sleep health and mobility. We try to bring new expertise and combine with Bumrungrad Hospital with our specialist to develop program for these functions. Next year, second half of this year and next year, we will focus more to treat the disease like diabetes, hypertension, heart disease, cancer.
We will bring program to combine, integrate with the Bumrungrad Hospital. Another key success that make the patient come back and repeat visit at VitalLife. We use the wellness tree to have a holistic approach, and we develop wellness plan to let the patients understand that what is the plan for them this year, what is the objective, for their health, how we can fix their health concern. You know that our patient is highly educated. They are, they are executive, they are rich people. When they see this plan for themselves like this, they appreciate a lot, and this is one of key differentiators of VitalLife compared to other center. For our marketing and communication, we focus both direct to customer. We also have a B2B and corporate partnership to take care of their executive.
In many industries, in the property industry, in the financial industry. We have the program that takes care of their executives and their data of their customers too. Thailand Elite is another program that we work with the rich people that come to visit Thailand and have created program designed according to their health concern. We focus a lot in the pain point or concern from the patient. Not only give the product that we have, but we try to bring the outside in to develop program for our patient too. Our online and digital program is one of the good channel that we can see growth a lot during this two year.
We use the telemedicine with international market. Now we promote and educate our patients by Facebook Live, by YouTube channel, and we use line communication to convert the sale from the one who interested from the other platform. This help a lot to increase the new case. We also have a key strategy in the second half of this year with a new service. Now we will bring new innovation and technology about the hair clinic, hair center. Sexual health, this is a main concern of Middle East market, and brain wellness clinic. This not only bring technology, but we have doctor and specialists from both, we recruit new doctor and from Bumrungrad Hospital that focus in integrate the treatment for wellness.
For the customer journey, we will try to offer the best service experience, not only clinical experience. As I informed earlier, this year we will go out more. I will fly almost every month to Myanmar, to Middle East, to Cambodia and our focus country. VitalLife expansion. This is the new era of VitalLife that we can expand more to other location but we can update about this expansion in the next quarter. Thank you, Kap.
Thank you, Dr. Narinthorn. This concludes the second quarter 2022 analyst presentation. See you in the live Q&A session for those of you who are invited. For those who are keeping track of Bumrungrad, the third quarter results will be released on the tenth of November with an analyst presentation followed one week after. Thank you, Kap.