Good morning and thank you for standing by. Welcome to Dasa's Fourth Quarter and Full Year of 2022 Earnings Video Conference. We would like to inform you that this event is being recorded. After the presentation of the company, there will be a question-and-answer session for analysts and investors. If you need assistance during the conference call, please press star zero to speak with the operator. A link to access the webcast transmission with audio and slides is available on Dasa's investor relations website at www.dasa3.com.br. The presentation is also available for download on the website. We point out that any information contained in this presentation and any statements that may be made during the video conference regarding business prospects, projections, operating and financial goals of Dasa constitute the beliefs and assumptions of the company management, as well as information currently available.
Forward-looking statements are no guarantee of performance and involve risks, uncertainties, and assumptions, for they refer to future events and depend on circumstances that may or may not occur. Investors should understand that general economic conditions, market conditions, and other operating factors may affect Dasa's future performance. Now, I will turn the conference over to Mr. Glauco Desiderio, who will start the presentation.
Good afternoon. Thank you for attending this call. We will start the presentation with the remarks of Pedro Bueno, Dasa CEO, followed by Felipe Guimarães. Also here with us are Andrea Dolabela, General Manager of Product Marketing and Experience, Emerson Gasparetto, General Director of Hospitals and Oncology, Rafael Lucchesi, General Director of Diagnostics, and Nelcina Tropardi , Chief Legal Officer. Everyone will be available in the question-and-answer session. I turn the call over to Mr. Pedro Bueno for his delivery.
Hello, everyone. Good morning.
Welcome to our earnings conference call. We present a short presentation for you. We are going to start providing context for the year 2022. We'll go deeper into our results for the year, and then I'm going to ask closing remarks for our perspectives of 2023. 2022 was a year where our strategic investments, our strategy started to pay off. We grew 26% in our gross revenue. It's a company which is already 50% on oncology and diagnostics. We made a very important advance in our digital business on oncology. As you can see, strong growth in revenue, but also growth of gross margin year- over- year. As we enter the year of 2022, if we compare the fourth quarter of 2022 with the fourth quarter of 2021, almost 50 percentage points of growth of gross margin on hospitals and oncology.
We are very enthusiastic with the integrations that we have been doing with M&As and hospitals. As to oncology, it's our thesis to use diagnostics in hospitals to feed the growth of our outpatient oncology with a growth of over 40%. I'm not going to follow the order of the slide. I'm going to skip some points and go straight to the Nav. As to Nav, we have nearly 6.5 million registered users across the country. We made headway expanding our user base, now focusing on engagement and generation of revenue. This worked well. This was an year of the transformation of people and culture, which was very important to the company, especially for oncology and hospitals led by Emerson. We have just formed a group of our hospital team, and the results were very successful.
We were very successful in the careers, and we had big advances in the commercial area. We can see the payoff of what we have done last year, among other adjustments that we made, and these are not the big ones. If so, this was a challenging year, a year where some things happened in a different way than we expected. Now going to diagnostics and coordination. In the first months of the year, we had revenue, growth of revenue higher than we expected. We responded quickly and implemented important adjustments focused on four levers: commercial contracts with operators, the management of offers and tests in our unit through the. We considered the revenue according to the square meter in our unit. This drove the growth of this business.
Our focus on digital experience with check-in and also the digital consultation scheduling that is going to bring about efficiency, but also growth in our revenues, considering that you have a lot of loyalty with our clients and also all the businesses in diagnostics, which is related to operator, out of brand in our home collections. The good news is that in the fourth quarter, we can observe a growth of diagnostics ex-COVID. Especially at the end of the month of the year. In the fourth quarter, we, for the company of diagnostics that grew the fastest in the period. As you are going to see at the end of the presentation, the first quarter is very enthusiastic, also in relation to diagnostics. I am going to share some information related to this at the end of my presentation.
Another front that we could have done better last year was the corporate expense I mentioned. We reached a peak in the second quarter of nearly 50% of our net income, which was consumed by administrative expenses. We reached the end of the year with 50% less. The dilution is happening, but we could have been faster. In October, we opened a project, and we looked at the effect of centralizing the activities, and we went deeper into our administrative structure, and we had very positive results from this project. We have already implemented most of the items on the project in February this year. We understand that this corporate dilution will accelerate this year, as I mentioned, in the fourth quarter, with 2.40%.
This is an informal guidance, but we are going to go after this efficiency in relation to the net income for 2023. Another front that we could have done differently last year was related to our focus on leverage. This is the priority top of the company now. We have different fronts, and we are going to go over them so that we can improve our future structure, prioritize our cash generation. This came from the lessons we learned and identified at the company last year related to cultural transformation. Fortunately, I have a good mentor. Localiza is my mentor, and we have been implementing different changes, incentives, KPIs. We have been implementing many efforts in 2023 focused on cash generation and leveraging. I turn the call to Felipe.
Deeper into the results of 2022, then I will come back to talk on the prospects for 2023. Starting on slide six, gross revenue records a significant growth of 21% this quarter, pointing out the progress in the maturity of Dasa ecosystem. The revenue for the business of hospital and oncology presented a growth of 49%, reaching BRL 1.8 billion in the quarter, with significant growth in the two segments that make up such a business. Looking specifically at the segment of hospitals, the 50% increase year- over- year is explained by the increase in the number of beds in the period, mostly due to recent acquisitions and the average ticket due to greater complexity and contractual readjustments in the last 12 months. The same for oncology. The 40% growth also comes from an increase in volumes and in the average ticket.
We performed approximately 127,000 procedures, including infusion, radiotherapy, and consultation. Moving on to the business of diagnostics and coordination, revenue for the quarter totaled BRL 1.7 billion, an increase of 2% year- over- year and 6% ex-COVID. In the segment of diagnostics, we can see a 7% growth in gross revenue compared to the same period last year, 13% ex-COVID, which shows a resumption of growth in the segment and a gain in market share from the fourth quarter onwards when compared to our major peers. Even with the additional impact brought about by the seasonality of the World Cup, we managed to deliver a good result coming from larger tests and larger average ticket. Second, in the segment of care coordination, we draw your attention to the one-off effect brought about the recognition of a lower-than-expected gain related to profit-sharing contract.
I will provide more details on this topic on the BU2 gross margin slide. Moving on to slide seven, BU1 gross margin continues to show strong progress, supported by the management efficiency and synergy gain, ending the fourth quarter of 2022 at 28.2%, an increase of 13 percentage points compared to the fourth quarter of 2021, and showing a clear upward trend. When we compare the first half of 2022 and the second half of 2021, growing by 10 percentage points. It has been one year since we assumed the assets, and we can confirm the integration strategy was successful. In these 12 months of consolidation of the growth strategy and relevant margin gains, we remain confident in the continuity of the margin improvement process. Moving on to slide eight, we present the gross margin of diagnostics and care coordination.
28.2% in the fourth quarter of 2022, a reduction of 7% in comparison to the fourth quarter of 2021, and 3 percentage points when adjusted by the profit-sharing contract. Therefore, it is important to segregate segments that make up this view for a better understanding of the results. Starting with diagnostics, which recorded a drop of 3 percentage points due to the following effects: the reduction of the share of COVID tests, which can be seen more clearly in the graph of the lower side corner of the slide, and the FX effect in international operation, which reflects a reduction of 1.2 percentage points. Going to care coordination, we see the one-off impact. In a summarized way, in 2021, we had two integrated care contracts in the segment, and we share the gains by reducing the claims in a certain portfolio along two years.
These operations had positive results in the period, however, lower than the first year, and that is why we made this adjustment this quarter. This reduction represents a little bit less than 10% of the revenue, and due to the high complexity of this kind of contract, this modality is no longer a focus for us, and that is why we are back to operating the PMPL mode. This impact explains the gap of approximately 4 percentage points in the comparison between the periods, as highlighted in the upper left graph. Here on slide nine, we highlight the dilution for the second consecutive quarter of our G&A, in line with the company's efficiency and productivity plan.
Some important adjustments are being carried out, and the annualized impact of the reductions will be savings of approximately BRL 100 million, which should be largely along the year, given that most of them will be finalized by the end of the year. The first quarter of 2023, more specifically. The result of this work front should lead to a significant dilution of G&A throughout the year, coming to levels lower than 2021 in terms of percentage of the revenue. Now on slide 10, we show the evolution of our adjusted EBITDA, which showed a 42% increase when compared to the fourth quarter of 2021. In addition to a 2 percentage points growth in the margin for the period. Now, looking at the snapshot of the second half of 2022, we see an increase of 23% in comparison to the same period last year.
This snapshot is important given the advances in conducting our business during the second half of 2022, and considering that there is a distortion caused by a high volume of assistance related to COVID-19 in the period. Now moving on to slide 11, we show the Digico strategy and the Nav platform monetization funnel. Starting at the top, we can see that we have been very effective in increasing our user base, both patients and physicians. At the end of Q4 2022, we already had 6.4 million individual patients and 37,000 physicians registered on the platform. Very expressive growth in comparison to the same period of the previous year. Of the registered users, we noticed an increase in the recurring use of the platform, showing a greater engagement of the space.
The number of monthly active patients grew 1.6 x this quarter when compared to the same period a year ago, while the number of weekly active physicians increased 2.2 x over the same period. Finally, we can see that there has been a robust advance in the reach of our services, measured by the number of qualified access that grew 2.2 x, generating even more opportunities for navigation.
Now on slide 12, we are going to talk about leverage, where we closed, for the purpose of covenant, 3.87 x the value of the net debt over adjusted EBITDA. Our net debt ended the quarter at BRL 8.4 billion. It is important to point out that in line with our strategy of liability management, we continue working on the optimization of the future maturity schedule, where we had two important operations, as you can see on the lower part of the slide.
Having said that, I turn the call to you, Pedro.
Can we move on to the next slide? Let's talk about capital structure. Our absolute priority for the company is to generate cash and to improve our capital structure. We brought some opportunities that we have prioritizing. The first one, obviously, is the strategic opportunity that we mentioned in the material fact that we released on Friday. As you saw in the material fact, we have been engaged in a potential public offering of shares that have been discussed by the company. The second point is CapEx. We have been making a robust reduction in our CapEx. The CapEx of 2022 ended at BRL 1.3 billion. What we want for this year is not a formal guidance, but in 2023, we want to spend with millions, not billions, focused on 5% of the net income.
This is not a formal guidance, but this is what we're going to go after. That means that we still have some room for important investments that we're going to have a positive prioritization for the company. We're going to choose more strategic investments with return which are higher. We have made many investments in the past three years. We have a lot of contracted growth. We want to realize the CapEx that we have already used. We are going to be more conservative this year in terms of CapEx. Third, we bring possibilities of sales back, lease back. We have the São Domingos in Maranhão and Hospital da Bahia in Salvador. These are two assets that came together with those M&As. We are talking to potential investors.
We do not want to provide a formal guidance, but we intend to invest up to BRL 600 million in the short term. Fourth, another is to reduce the working capital days. These are things that are in our hands at the moment. We see opportunities to improve this aspect along 2023. Item five is that we will continue seeking efficiency, especially in G&A, that is going to bring us major profitabilities for 2023. The conclusion of all this, to give you an order of magnitude. We see the improvement opportunities in the capital structure. Excluding the improvement of our EBITDA, we're talking about BRL 3 billion of new capital for the company in 2023. With this, we are going to improve significantly our capital structure. Another front we're focusing is to reduce leverage. We also want to generate more cash.
As I said, we are going to be more conservative with the G&A and CapEx, and we're going to focus and reach the breakeven of our cash generation. This is not a guidance, as I mentioned before. We're going to focus on lowering our net circuit as well. All those strategies that will improve our capital structure will operate to reduce the leverage of the company and into 2024. We will have the operational evolution of the company, and we are likely to have a very positive cash generation, speeding up our deleveraging process. In the medium term, we want to be at a comfortable position of 2x. This is what we're going to go after in the medium term. Now talking about the outlook for 2023, we are very enthusiastic about 2023. One more slide, please. I've just mentioned the capital structure.
This is our absolute priority, as I said, not in terms of leverage, but also in terms of cash generation. We are prioritizing this at the company this year. As for hospital and oncology, we are on track of all the integration that we started. Even considering all this, there's a long way to go yet. So, we expect to continue evolving, expanding our organic growth, and we are also going to improve our targets for 2023. We have been working on four growth levers for this business, which are outpatient clinics, digital outpatient clinics, generating consultations and procedures, conversion of the surgical center oncology, as you saw. Oncology is growing at a fast pace, and the combination of all this.
The last one, which is related to navigation of new patients, this is an initiative that we have where we create an algorithm that would connect the image report and will identify whether or not the patient will require a hospital service. We are going to use the test, the result of this exam, in order to convert into a hospital patient. What we observed in the first quarter is that we saw an organic double-digit growth when we compare it to the first quarter of the previous year. For diagnostics, we have been working on the levers of growth along the second half of last year, leading to the growth that we reported. This is also helping the growth of the first quarter. I am not going to repeat all the levers because I have mentioned them at the beginning.
In the first quarter, of course, this is not a formal guidance, but we have observed an ex-COVID growth. If you observed in 2022, in the first quarter, we had important revenue. But when you look at the growth ex-COVID, comparing these periods, you understand that we have reached double digits, but it's not a double digits. We are on track to increase our share in the diagnostics business, and we are also focusing on digitalizing our businesses to improve the margin of this business unit. Fourth, navigation. Navigation is a big upside for the company this year. So we are working not only navigation using our platform, but also we are considering other sorts of navigation that do not require all the Nav-related technology. So we can already start capturing results in the company. We have five important fronts.
One is the outpatient clinics, and the other is care coordination. This is something that can be converted to use digital diagnosis with data, our broker, NLP, which is the initiative that I mentioned, and other navigation tools that we have. So we expect that we have been working on aggressive targets for the company so that we can pull the total organic growth of the company in 2023. We are very enthusiastic about all those opportunities. Many of them are not budget. They are upsides considering the numbers that have been planned. Lastly, the SG&A.
As I mentioned, we are very confident with the SG&A that I mentioned because we have already implemented the actions in February and March, and there are some other actions to be implemented in April, but we have already done the hard work, and this is going to bring about a lot of efficiency in the expenses of the company. When we look at all this, we expect a year with healthy growth, organic growth, an improvement in profitability, and a very important improvement in the capital structure. These are our focus for 2023. I think I can now open the Q&A session. Thank you.
Thank you. We are now going to open the Q&A session. To ask a question, please press star one. You can use the webcast platform if you want to ask a question. Our first question comes from Vinicius Figueiredo with Itaú BBA. Good morning, everyone.
Thanks for taking my question. The first point I would like to discuss with you has been bringing all the points that you mentioned in terms of operating improvements for 2023. The SG&A is something that has already been diluted along 2022. There was a sequential improvement in 2022 already. I understand that you are not going to provide the formal guidance, but to which degree this can reach as a percentage of the revenue? I would also like to know some more, not only about the paying sources, but also the environment of those payment sources. We can see that the follow has been improving. I would like to understand if you are being very conservative, and if you could provide some more light in relation to this, I would be grateful. Thank you.
Hi, Vinicius. Thank you for the question.
To answer the first point, yes, we expect an acceleration in the dilution of the G&A. You saw a curve in the previous quarters. We dropped by 1 point, but we want to drop more than this. We want a stronger reduction. So, we like to expect levels much lower than we had in 2021 that we showed you in the presentation. In relation to your second question in terms of receivables, we do not expect an improvement of receivables for this year from the operators. For a better cash generation, we want to improve internal processes so that we can cause a positive impact on the negative scenario. This can be related to inventory levels and the payment terms. We understand that it is a lot to do yet.
Second, our receivables process is even more robust internally, and we can see this in the percentages of receivables that we saw, and we have been reducing these follow processes year-on-year. This is a result of internal processes that is going to be reflected on the results that can offset any negative scenario from negative receivables from other operators.
Okay. It is clear. Thank you.
Our next question comes from Yan Cesquim , BTG Pactual.
Good morning, everyone. I would like to ask two questions. First one is related to BU2. It was very clear that you have a positive message to give us in terms of growth of revenues ex-COVID for the beginning of the year, but I would like to understand a little bit better the mix considering COVID.
We saw that in the first quarter of 2022, we still see this impact, and that brought a positive impact to the margin. Where can we see this turning point? When is it going to happen when the organic growth and the operating leverage is going to offset this COVID coming out of the scene? Are we to see this at the second half of 2023? Is it fair to say that? The second question is to measure your perception on. We see that the level of, this fall in the market happens at the macro level in the chain. Can I see during how you observe this, especially at the beginning of 2020. Do you see any improvement?
Thank you for the question. Okay, here we go. It's an excellent question.
We are going to feel this effect that you mentioned in a big, strong way in the second quarter of 2023. For the first quarter, we still have an impact of Omicron of last year. COVID still impacts the revenue. As Pedro mentioned, we have been accelerating the revenue operations to offset this drop. But for the second quarter, COVID impact is going to be much lower. We have the positive effect of organic growth impacting the operating leverage, and then we will go back to have the margin growth, down the road as we expect. To answer your question, as of the second quarter, this effect is going to be much greater, especially for the second half. If you observe the levels of impact of COVID, there is a decreasing level. For the second quarter, it's as if the baseline is already 100% corrected.
What about this allowance? As I mentioned, in terms of this allowance, our performance has been very positive. We have been able to reduce this allowance year after year, and in both businesses, both for diagnostics and the hospitals, and we are working hard on these allowances, which are initial, that can impact the terms of receivables because this allowance at first have some discrepancies. Then in the future, you're going to see if it's going to be accepted or not. The discussion can take long because of this discussion. The focus is to guarantee that the process is very robust so that the PRR can be well reflected. We have lots of opportunities to look at along the year so that those effects will not offset any negative scenarios coming from outside.
Perfect. Thank you, everyone.
Our next question comes from Gustavo Tiseo with Bank of America.
Good morning. I have two questions on our side. Out of curiosity, I would like to understand what the status of more mature hospitals, considering the Nav that you have when the beneficiary is on the focus, not just your hospital, because occupancy rate is very relevant. Can you bring in higher efficiencies to those mature hospitals, or are those efficiencies more clear in the new hospitals when you talk about Nav? The second question relating to coordination. There were two agreements that you mentioned. I would like to understand how far can we see those values impacting the diagnostics in a negative way. We want to understand the impact. Even though you are changing the types of contract, I would like to understand that. These are my two questions. Thank you.
As for hospital and navigation, which is a very important lever for us, for the company, for the strategy of the company as a whole. It brings in revenues and profitability to our assets. In addition to that, it would mitigate some gaps. This improves the efficiency. We do not have. We have integrated hospitals and also other hospitals. In all of them, we see opportunities to increase our revenue using this lever. The occupancy rate is about 75%. This shows that we still have a good opportunity to occupy our assets, leading to 80% or 82%. From the operational viewpoint, this is very relevant to those hospitals. We have the capacity to support this growth coming from our strategy.
As mentioned, not only navigation, using the image and reports, but also for patients who need some services which are not emergency services, but they need follow-up of their outpatient service and navigating to hospitals when necessary. So ensuring that the gaps are going to be looked at with the cost-effective ratio and everything. Answering your second question related to coordination of care. This is a business that we see a lot of potential. We have been able to generate a lot of savings to the operators. This specific contract, first I would like to say that we just had two performance contracts in this business, and these are contracts that have no downside risk. In other words, we can capture the savings, but if anything gets worse, nothing negative will happen. So in this contract, you can give back the gain that we had.
In 2021, we had a positive gain. The claims were very positive. In 2022, we returned part of the gains. We had a gain of 50 in 2021, and we returned 30 of those 50 in 2022. When we see the lifelong period of those contracts, it was very positive for Dasa. So, you say, why are you going to discontinue this? Why? Because there is a lot of discussion with the operator. We understood that the NBMs and the commercial results are going to be more accelerated, as we have seen in the first quarter of 2023. We are not going to sell new contracts of performance, and we just have this one, the only one which was left, and we do not expect any relevant negative impact for 2023. So you can disregard this aspect in your projection.
Okay. Thank you. Thank you for the answers.
Next question comes from Mauricio Cepeda with Credit Suisse.
Hello, good morning. Thank you for taking my questions. I am going to concentrate on diagnostics. In general, what have you been doing to increase the registrations? What has been the proposition of value, and how is this process playing out? What have you been doing in order to bring in more traffic, the tools you have been using? Since you have this natural advantage of having different brands, how have you been linked to other services, B2C, and what are the prospects in this area? Thank you.
Okay, here we go. What do we have in terms of the tools for new registrations is a continuous work.
We have been able to register our unit and services which were not registered, thinking about the products offered by the operators, because sometimes we have a group of products which are already registered and the other ones which are potential products. We have the potential of managing the portfolio in order to have new registrations. How do we go about it? We have a competitive advantage, which is the segmentation of the markets. We can operate using this segmentation, using different products, and with the clarity in different segmentation. Sometimes we can provide the complete services for the operator. With this, we can offer a complete care package. We can segment it by means of prices and services, and this has been a very good proposal to the operators. This is why we have made new important commercial contracts.
We have increased the volumes, and this has been happening since the fourth quarter. This has been playing out since now. What have we done in order to capture this volume? Oftentimes, we need to expand the service offer. As Pedro mentioned, we have invested a lot in the past years, so we have the capacity to expand the services in the unit. This is what we have done with a double positive effect, which is bringing in revenue, and since we have fixed costs already established. We can have an additional profitability, because we dilute the fixed cost. We grew in volume, and we dilute expenses. We have a possibility to make more profit. This all added to the digitalization, the scale, reduction of costs.
All of this bring in a positive sign, and we are very confident that we are on the right track for 2023. Thank you very much for the question.
I would like to remind you that if you wish to ask a question, please press star one. To withdraw your question from the line, press two. Please wait while we collect new questions. Our next question comes from Renan Prata with Citibank.
Hello, good morning. One quick question on my side. You have already addressed very well the main points during the presentation. In the Q1 on oncology, what are the opportunities a little bit before Nav? Is there any opportunity in the gross margin in terms of gains in efficiency, especially the newly acquired hospitals? I would like to know if there is any room for increasing the gross margin.
Yes, all those topics a little bit before Nav in the presentation. I do not know if I am still connected. Just a moment. We are having a look. We are checking this out. Yes, we have opportunity to increase the gross margin in hospitals. We have a lot to capture in revenues. As to navigation, and navigation is not limited enough. Navigation means that we are going to meet all the gaps. Oncology, as we mentioned before, has been growing quite a lot. We have a thesis that early diagnosis is very relevant, and we are going to provide a better outcome considering early diagnosis. Still, we can see a big evolution in third-party services and personnel. 2022 was sensational in this term.
We had significant evolutions in 2022, but there is still room to be captured as we mature the actions adopted in 2022 and also 2023, and also in the line of medical costs that we are working hard on. If we compare to half of the year, we see the run rate of the business, and this is how we are going to work in 2023. As I mentioned, the levers in a summarized way that I described are the ones that we are going to use for 2023.
Okay. Thank you. Perfect.
Our next question comes from Marcia with Bradesco.
Good morning, everyone. I have two questions. The first is related to diagnostics. I would like to understand how much of this acceleration of the growth comes from new contracts and considering this growth, how the public segment is going to be affected.
This is also around the reference segment. As for hospitals, when the price negotiations happen with main source, main payers, if we consider the three main payers, when do the negotiations happen? Do you see any sign of a tougher price negotiation when compared to last year demanding reduction discounts? These are the questions. Thank you.
Marcia, thank you. I am going to start answering your question about hospitals, and I am going to turn to Lucchesi to talk about the other topic. As for hospitals, the contract anniversaries are distributed along the years. We did not have a quarter specific that we would have a big concentration of negotiations. Hospitals have the agreements that are negotiated in the second half of the year. Some of them are negotiated in August. We are continuing with our strategy for hospitals, where we go for IPCA+. Why?
Many of the hospitals we acquired have the lower standard. When we look at our peers, we see that there is like an umbrella of prices where we can define the prices with our hospitals, and we can be more efficient. In addition to this, our model is six efficiencies. We have to combine the price lists and the operating activities. We are going to use a strategy because we are comparing to our peers. We are going at IPCA first. I am going to turn to Lucchesi so that he can answer the question about diagnostics.
About the growth in diagnostics. We can see the following. More than half of the growth comes from commercial leverage considering volume prices, and half of the growth comes from levers of business operations, such as expansion of the agendas, expansion of services, new services with high growth levels, such as out of brand and the premium brands that always pull our growth upwards. The level experience that we offer the users, we can see that there has been an increase in the recurring use. The use of Nav, the use of JK, the use, this consumer experience. We have a very clear plan of growth, where the revenue growth found, where the volumes will come from. We can see the exhibition half from commercial levers, but incremental volume, price adjustments, and the other half comes from the actions in the business and in the operations. Related to Emerson's answer.
The most efficient operating model would be the protocols, then the average expense would be lower per patient. Is this it? Or are there opportunities to improve this average ticket in addition to the price list? Yes, for sure, because the average ticket is based on the price list, but it's also related to the complexity level. As Emerson mentioned, one of the main growth drivers to this BU is oncology. Oncology generates hospital events and surgeries of high complexity. So we are not dependent only on the price list, even though this is going to be very useful for the company in 2023. But there's also the complexity aspect to be considered.
When I say operational model, I mean you have to see the conversion of first aid services to hospitalizations, to use, and we do the management according to those indicators, and we share those indicators with the operators, showing the efficiency in our work as a value. This is the opportunity we see.
Okay. Thank you. Thank you, everyone.
The Q&A session has ended. I would like to turn the call over to Pedro Bueno for his final remarks.
Thank you very much for the call. As I mentioned, we have had important lessons learned in 2022 that have been applied in the beginning of 2023. Encouraging results and focus on cash generation, capital structure, and also monetizing all the investments that have been made in the past few years that are going to contribute to a very healthy organic growth for 2023.
I would like to thank you all and see you in the next quarter. This is the end of the conference. We would like to thank everyone's participation and have a nice afternoon.