Dasa. I would like to point out that those of you who need simultaneous translation, we have this tool available on the platform. Just click on the button that says "Interpretation" in the lower part of your screen and choose your preferred language, Portuguese or English. This is being recorded and will be made available at the site of IR of the company. During the presentation, to make a question, please click on the Q&A button at the lower part of the screen. Add your name and enter into the line of questioners. You will be announced. Your microphone will appear on the screen, so you will be able to make your question. These questions will all be made at just one time.
We pointed that the information in this presentation, and anything that may be said during the company conference about the perspectives of business, of the projections or operational methods of Dasa, are beliefs and premises of the company, as well as the information currently available to the company. Future projections are not guarantees of performance. They involve risks, uncertainties, and premises as they refer to future events which may or may not happen. Investors should look at the economic conditions, market conditions, and other factors. Operational factors may affect the future performance of Dasa and future performance. Now I am going to pass it over to the Director of IR of Dasa.
Good morning. Thank you all very much. I am going to start our presentation with a few considerations of Pedro Bueno, President of Dasa, followed by Felipe Guimarães, Financial Director.
We also have Andre Dolabela, Director of Products and Marketing, Emerson Gasparetto, Director of Hospitals and Oncology, and Rafael Lucchesi, General Director of Care and Diagnostics and Coordination. All will be here available to answer your questions as soon as we finish the presentation. Okay, and now Pedro Bueno.
Good afternoon to everyone. It is a pleasure to announce the results of the second quarter of 2022 of Dasa. In the period, we continued to grow in execution of our business planning with robust growth, the integration of our acquired companies, and the evolution of our digital platform, Nav. We know that we still have lots of opportunities for the implementation increase both in the gross margin as well as in the dilution of our G&A. That is why it is important to mention that measures have been mapped out and are prepared by the management of the company.
We are confident in the continuing process of improvement of margins, and shall continue to gain strength in the second half of the year. Go to slide four, please. We had solid financial. We had BRL 3.5 billion in a growth of 24% compared to the second semester of 2021. The growth of our revenue. First of all, the growth of 76% in the gross revenue of our oncology area, a result which represents 29% of the consolidated revenue of the company in the second quarter. An increase of 12.8% compared to the same period in 2021. This first half of the year, we consolidated all of our acquisitions from last year. In second place, we had growth of 8%, excluding the impact of the COVID, in the unit of outpatient care and diagnostics and coordination of care, with increased volume of examines and average ticket.
In the front of digital initiatives, we continued to deliver consistent results in the execution of our strategy in the Nav strategy, once again increasing the base of new registrants. The base reached 4.6 million users at the end of this quarter, a reflex of our leveraging of the current strengths of our core business to help the platform to grow. The number of new users compared to the patients in Nav reached 1.1 million in the second quarter of 2022, six times more than in the second quarter of 2021. We had 3.4 thousand new doctors in the quarter, maintaining the trajectory of acceleration of growth. With these additional doctors, the number of medical users reached 29,000. The telemedicine consultations increased 26% in the second quarter compared to the second quarter of 2021. This year, 138,000 teleconsults were registered by the end of the quarter.
The web check-in services reached 495,000 users in the quarter, a growth of 23 times compared to the 20,000 users in the same quarter of 2021. With the mission of offering the health that people desire and need, we advanced in a relevant way in the expansion of our ecosystem. In 2022, we inaugurated our first integrated space in Alphaville, in the city of Barueri in São Paulo, reuniting Alta Diagnóstics which together will offer a complete health experience to our clients. We also inaugurated in the quarter two new Alta units in the city of São Paulo and Barueri. In May, we completed the acquisition of Centron, a reference center in oncology in Rio de Janeiro, and finally, in June, we announced the acquisition of Lustosa Laboratory in an important mark in the strengthening of our presence in diagnostics in the metropolitan region of Belo Horizonte.
Going to slide number five. As I mentioned in the previous slide, we closed the second quarter with a record gross revenue of BRL 3.5 billion. Based on the graph on this slide, we can observe that our revenue has grown consistently and sequentially over the years. Fruit of the successful advance of our strategy of expansion and integration and the navigation of our users among our assets. Going to slide six. It's also important to mention that as we present the evolution of the profitability of the company of oncology hospitals, even with the increase of the participation of acquired companies in a process of integration, which generally present lower contribution margins than the other assets in the first moment.
As we can observe in these graphs, the improving of the gross margins when compared to the second quarter of 2021 occurred even with growth of 57.2% in the total number of beds. The evolution of this margin is a result of this more efficient operation of our hospital assets, integration of the acquired companies, and the improvement of our operational indicators. Our revenue in this period was forced by the occupation of beds and the increase of the amount of complexity in our hospitals, and the attraction and retention of medical teams with very high qualifications. Going to the next slide. We present here the evolution of our platform, Nav, in the second quarter, and we continue to invest in technology in this area. In this quarter, the number of new users in the platform was 1.1 million, resulting in a total number of users registered of 4.6 million.
This represents a growth of 144% when compared to the same period of the previous year. Beyond the patients, Nav Pro was a good app for the doctors. It reached 49,000 users with a growth of 127% compared to the same period of 2021. The robust growth of users occurs at the same time as evolved our evaluation of our users in the app stores. In the second quarter of 2022, the Nav received a note of users of 4.6 on a scale of one to five . This evaluation increased in relation to the evaluation of 3.7 registered in June of 2021. The Nav platform has become one of the more and more important channel of connection between patients, doctors, strengthening the experience of the users, and continues to gain efficiency for this health sector.
On our side, we continue to dedicate to the development of the platform, looking at the improvement of functions which can generate better involvement and recurrence of our users. Going to slide number eight, please. Our service of web check-in went over one million users since it was launched last year, including 496,000 in the second quarter of 2022. This initiative represents 19% reduction in the average time of people waiting versus the traditional check-in process. Beyond reducing the time of waiting and improving the user experience of our patients, with this experience, we've been able to increase the efficiency of our units, especially in relation to the reception area. Another important component of our strategy is the navigation of the user in our system through the experience which generate involvement.
We continued to evolve over the second quarter with an increase of 851% in the number of accesses to the Nav when compared to the second quarter of 2021. Our consultation via telemedicine, which offers on the platform, increased by 26% in spite of the cooling of the pandemic. In the first half of 2021, we had 238,000 teleconsulting, and the tendency for growth continues positive. In this quarter, we have 15 specialties available on the platform compared to nine in 2021. Going to slide number nine to talk about our strategy of expansion. Starting with hospitals, since the beginning of 2021, we've more than doubled the number of units in our portfolio, going from 7 - 15. As a consequence, the number of beds, total beds, has also doubled, reaching 3,417 by the end of the second quarter of 2022.
With that, we count on a command center latest generation. It's where the second-largest private platform of hospitals in Brazil. In the segment of oncology, we almost tripled the number of units of service, going from 12 at the beginning of last year to 35 currently. We're present in seven states and in Brasília, and we are today the third largest independent oncology group in Brazil. In the segment of diagnostics, we count on 1,000 units and more than 34 with technicians maintaining our leadership in the segment in the country, both in sales as well as in number of examinations. We increased our amount of capacity to be able to attend these patients during the entire journey in important markets. This offers a better experience to users and it increases and reinforces the brand and our ecosystem strategy.
As mentioned at the beginning of the presentation, in August, trying to strengthen our positioning as the biggest integrated network of medical care in the country, we inaugurated our first integrated health space in Alphaville, in the city of Barueri, uniting the Alta and Nav brands, which will offer a complete health experience to our users. These new concepts offer a complete structure including fast care, surgical care, medical consultations of several specialties, clinical analysis and image analysis, oncology, health space for the woman, and diverse other services. We also inaugurated two other units of Alta in the city of Barueri. Beyond the organic expansion of our network, we also continue to execute our strategy of growth through acquisitions, especially hospitals and oncological centers. In the last 12 months, we have created eight assets, strategically located, which added 1,768 beds to our portfolio.
In May, we concluded the acquisition of the Centron, specialized in oncology in Rio, and also led by Kabbas , who is a reference in oncology in onco-hematology, in the southern zone of Rio de Janeiro. It has 18 fusion chairs, eight medical consult centers, and in 2021. In June, we also mentioned the acquisition of Lustosa Laboratory , an important mark in the strengthening of our presence in diagnostics of Dasa in the metropolitan area of Belo Horizonte, the third largest market in Brazil. Lustosa is an important brand with 26 units, making it possible, beyond the capture of synergies, expressive operations, along with what Dasa already has in the region. On slide 11, we are sure that in the middle of our network, we have the capacity to impact thousands of people, reaffirming our commitment with the sharing of values with our public.
In July, we advanced with our sustainability report for 2021. The report went through an external audit to guarantee the trustworthiness of the data, and this document is available on our IR site. Another highlight of this semester is that for the second year in a row, we had an inventory of greenhouse gases with a reduction. We have committed to be zero carbon by 2030. By 2022, in a voluntary way, we reached 100% of the greenhouse gases of our inventoried hospitals in 2021. Now to pass over to Felipe Guimarães, who will talk to you about our financial highlights.
Thank you, Pedro. On slide 13, we have the results of our oncology hospitals.
The net revenue grew by 69% in the second quarter in relation to the second quarter of 2021, hitting BRL 1.6 billion, fruit of the growth of number of beds, and grew by 61% compared to on an annual basis, reflecting the acquisitions realized in the period with the better utilization of our infrastructure. Also fruit of the growth of the rate of occupation, which registered growth of 0.8%, going from 77% in the second half of 2021 to 77.1% in the second quarter of 2022. The average gross ticket per patient, which reached BRL 8,300 per day, reflecting a better utilization of the beds for high complexities operations, affecting the negative impacts of the acquired hospitals in recent times, and the number of hospitalizations due to COVID in the previous period.
The profitability of the oncology hospitals with a gross margin of 16.3%, in spite of the process of integration of the new hospitals acquired. In the first moment, these have a lower contribution margin than the other assets in our portfolio. It is important to mention that the gross margin in the second half of 2022 was benefited by the combination of a high level of hospitalization, together with the suspension of the voluntary operations of the INSS. The velocity of the execution of our integration and the acquisitions performed last year is moving along well compared to the initial program. However, it is important to mention that we have more than half of our beds in mature hospitals, and which deliver lower gross margins, which is important in the continuous process of improving our margin, which should continue to gain strength in the second half of the year.
Following this, we are going to slide 15 to talk about the business units of the outpatient units. In this quarter, these units have been in growth of approximately 8% without the COVID numbers. However, compared to the second half of 2021, the average ticket went from BRL 534 in the second quarter to BRL 567 in the second quarter of 2022 for direct users, an increase of 9% in spite of the diminution of COVID in our numbers, and due to the number of examinations, which is 91 million examinations in the quarter. 1,000 exams in the quarter. It grew by going from 37% - 36.7%, principally due to the negative effect seasonal due to the mix and the utilization, especially of vaccines, which represent lower margins and lower expenses as a result of the inflationary impact on rent, fuel, and electric energy.
This quarter, we had the impact on the margin of BRL 47 million due to the operational expenses which were being recognized in our G&A. We now go to slide 16. We will talk to our consolidated financial results. As mentioned by Pedro, we closed the second quarter with a record gross revenue of BRL 3.5 billion, an increase of 24.7% in relation to the second quarter of the previous year. The adjusted gross profit reached BRL 976 million in the second quarter, a growth of 8.4% compared to the same period the previous year. Considering the adjustment mentioned in the previous slide, the gross margin adjusted had a reduction of 3% in relation to 2021 due to three principal factors. The impact of 1.1% due to the relevant growth of the participation of the oncology hospitals, which have lower margins than the diagnostic sector.
Second, due to the fall of the margin of these oncology hospitals of 2.6% due to an atypical semester as a result of the combination of the second wave of COVID in the country and the non-suspension of the optional procedures, and a reduction of 4% due to the things mentioned previously. The administrative costs, same one due to the recent acquisition, grew by 8% compared to going from BRL 320 million -BRL 417 million. A reflection of the company and the company due to the Nav platform and digital initiatives. It is important to point out that for comparison, we finished the second quarter with the impact of the BRL 47 million related to the cost of the operation, and that in the previous quarters were not classified as expenses.
The general and administrative expenses went to BRL 460 million or 14.1% of our net revenue, a reduction of 0.9% compared to the first quarter of 2022. The adjusted EBITDA was BRL 561 million with 17.1%, in line with the first quarter of 2021, which had the benefit of value of BRL 51 million. Going to slide 18, I want to mention about our debt and the cash position. We closed the second quarter with a net debt of 3.6 x EBITDA, a fall of 0.4x compared to the previous semester, by the position of cash and for payments related to M&A and working capital.
The net debt increased for the issuing of debentures in April of 2022. It continues to work on the management of this debt and our capital structure so that we can take advantage of the organic and inorganic opportunities in the future. Thank you all for listening.
Now I am going to pass it over for the question and answer session. Thank you.
When you make a question, you should click on the Q&A question on the lower part of the screen. Mention your name, the company, and your question, and get into the line. Thank you. The first question is from the sell-side analyst. Vinicius, please turn on your audio so you can make your question. Go right ahead, please.
Good afternoon to everyone, and thank you very much for your question. The question would be in relation to the average ticket of the Beyond. We see a fall in average ticket when we look at the behavior of the quarter-on-quarter behavior, and we see that there were several acquisitions consolidated in this quarter in that business unit.
I wanted to understand how would that have been in the organic operation, trying to isolate the effects of these acquisitions. If you could comment also how you see the complexity of these procedures within the hospital environment, and also how you are doing in terms of the other payers. Thank you very much.
Hi, Vinicius. Everything okay? You mentioned the first effect which impacted our average ticket in the hospital, which was M&A and new hospitals coming online year-on-year and having part of the impact. The other impact, which is more relevant, which is the mix of everything that we see in the first semester last year compared to this year.
We had the second wave of COVID last year with a higher complexity and seriousness than in the first wave, which represented a much higher number in our revenue compared to the first quarter of last year compared to this year. Looking at the impact of M&A, but also the impact of COVID. You have a higher level of elective surgeries and a lower level of ICU usage. So these are the principal impacts which affected this average ticket which was reported. In relation to the negotiations with the operators, we think this is in line with what we have been commenting with you in relation to hospitals who have been able to do diagnostics above inflation, but in line with what we have planned for the period.
That is clear. Thank you very much.
Continuing. Next question is from sell-side analyst of Goldman Sachs.
Gustavo, please turn on your audio so you can make your question. Go ahead, Gustavo.
Hi. Thank you for the presentation. Two questions from our side, two quick questions. One is related to BU2. We wanted to look at the premium brands, especially on the Alta brands, to try and understand if there is any relevant share gain in that company during this semester. When we look at this niche, it is a little more premium looking at the São Paulo operation. Pedro mentioned that we opened some stores looking at Alta in this niche. I wanted to look at a little bit of this effect. If you see any share gain in this segment, it might be interesting to understand that. The second question, an update in relation to the integration of the M&As which the company has recently done.
In this quarter, we saw the Paraná hospital coming in with a share. We saw several M&As during the year. We want to understand a little bit of the level of maturity that these guys are and see if we can see these hospitals migrating from stage one to stage two of synergies in accordance with the playbook which you presented.
Thank you very much. Gustavo, this is Rafael Lucchesi. Thank you for the question. The answer is yes. Alta continues with very growth above the market growth. The principal points are the arrival of new users, the very high level of faithfulness of our users, of Alta, and a very high level of recurrence due to the high level of brand loyalty. The new opportunities are not yet. There is not a huge impact on our growth.
However, we do have a lot of concern capacity to occupy in the units which are already opened and that we have been able to capture consistently. Our strategy continues of occupying the current units and units in strategic basis here in Alphaville and other units in Metas. Thank you very much. I am going to pass over to Felipe.
Thank you, Gustavo. Good afternoon. In relation to the integrations, we are principally. Majority of our hospitals are still in stage one, and they are only now beginning to deliver important synergies, but they still have an important part to enter, especially those related to the equalization of the systems. We need to equalize these systems, especially those related to SG&A.
There are important steps that were taken that affect our profitability, but there is still lots to do in the first stage of the integration, and the second stage is in parallel to the first stage. Therefore, which is the one that is the farthest ahead. Nonetheless, we had most of our assets are still entering between January and February. In the case of São Domingos , Paraná, AMO, and these other assets which have an important value to be absorbed within the first phase I of the integration.
Thank you all very much. Thank you, Rafael, for your questions.
Continuing. Next question is from Fred Mendes, sell-side analyst from Bank of America. Fred, please go turn on your audio and make your question. Go ahead.
Thank you. Good afternoon, guys. I have two questions here.
One, I am trying to understand better the dynamic, looking at the numbers of margin, starting with hospitals. I think you saw new hospitals coming in, but on the other hand, the concentration that comes in at the end of next year, looking at the Bahia, you should have a strong position if you do a ramp-up of this margin, and this margin should evolve. You should have this effect and the effect of the rate of occupation, which is very strong, but this should also help your margins. Last year, we saw that that margin was flat quarter-on-quarter, but quarter-on-quarter was flat. I want to understand this margin of the hospital's margin. The second question is also speaking about margin.
We saw the first quarter as being stronger in this industry, but the margin seems to be a stronger fall off, especially looking at these since Alta grew well. We understand that Alta should have a better margin than the rest of the business. You should have an important margin growth with Alta. Finally, I wanted to conciliate the dynamic of this in your margins. Thank you very much.
Good, Fred. The first impact on the hospital margins, what happens is as these are integrated with higher profitability below what we saw. But its first negative impact and the actions which are not only on the hospital level, but we have been dedicated for some time, as well as our business as usual. In the old Ímpar hospitals, the efficiency starts to hit the top, and this impact will be negative on the margins of the acquired companies.
It does not happen. That is what we see from the first to second quarter. But as Felipe mentioned, it is not every action or efficiency action we are capturing at the first moment. This is a continuing, ongoing work, and we look at all of the base, and it becomes easier for us to see in the next semesters. As far as the margins of BU2 is through Alta growing. We had gained margins there. The question is the relevance of Alta as a overall is still not as representative. So it is true, you are correct in the question of the gains, but in the representativity overall, it does not make that much difference.
However, the principal effects of this quarter, as was mentioned, of this half, were the inflationary curves, such as in the area of logistics, which is very important, the question of fuels, and also electric energy, which has an important impact, considered even seasonal in the second semester, where we will see an improvement going forward. However, we understand that these impacts, we are attentive to them, and at the same time, looking at the front of the execution of our digitalization, which in the long term will be fundamentally important to gain more efficiency and to improve our margins in the BU2 and the diagnostics area.
Thank you all very much. If I can make one follow-up question on your point, which I think is an important point.
Just to understand, when you buy a hospital, in the first moment, you have a gain of synergies in the first months, I imagine related to the repricing and something like that. Also a strong gain in the beginning, in the first few months. But it's not necessarily true during the second phase, which takes longer. In the second three months, you don't really gain anything or very little. So in reality, the margins will be flat quarter-on-quarter. Is that true? Is that correct? Or did I miss something?
In the first moment, you have the principal synergies, which are price list and G&A. In our book, we detail these, the first 30 days, 30 - 90, and then long-term, which go into brownfields, et cetera. The first actions, which are price list and G&A, they happen very quickly in the network.
The actions which take more to do in the operational model, such as the assistential model, the team changes and more complex questions and asserting the model, this has an impact which is more medium-term. They start in the first quarter, but they go maturing, and it will probably be felt more in 6 - 12 months when you'll see more relevant effect. So this model of bringing complexity to the hospital, increasing the operational census and in the acquired units is a more of a medium-term gain.
Okay, very clear. Thank you.
Continuing. Next question is from Mauricio Cepeda, associate analyst from Credit Suisse. Mauricio, please turn on your audio so you can make your questions. Go ahead.
Thank you. Thank you for taking my question. Good afternoon to all. I hope you can hear me. I have a few questions. First is very financial.
That's the question of the leverage that you mentioned in the presentation. I understand that the interest rates are still quite high. Do you have any plan to deleverage that might lower this net debt more quickly? That's the first question. The second question is in relation to the diagnostics unit. These are market units which has a higher visibility. To speak about that, how is the demand going versus the pre-pandemic levels? And what characteristics are you seeing in this demand? If it has a lot of routine or if you see exams related to distortions in that, and taking advantage of that, the thing that you mentioned of market share, how have you seen the market share gains? In what lines could you point that out? Thank you.
Okay, Cepeda, thank you very much. Good afternoon. I'm going to answer the question of leverage.
As you saw, we reached our peak of leverage in the first quarter. We saw the impact of this due to the closing of the conclusion of the majority of our deals. Then we started our process of deleveraging in the second quarter, which will since practically reduced quite a bit already the payments in our M&As. So reduced by 0.4%, and we believe the relation of cash to the previous quarters in the following quarters will continue to follow that same tendency, helping us to lower our leverage. So right now, it's a natural process of having a lower level of M&A, which will help us to deleverage the company by generating internal cash.
As far as the question of the diagnostics market, with our mix which came back very close to the pre-pandemic levels, ex-COVID.
And ex-COVID, we also had the characteristics a little different than last year when the COVID generated a lot of diagnostics such as tomographies. We can see that the general characteristics has gone back to a more normal mix, pre-pandemic mix, and we do not see any big changes in that sense. In relation to the market and market share, we see that we gained important market share last year, very strongly in COVID, but also in the ex-COVID. Our base last year was very high. We have accompanied this very closely, especially the question of long-term gains, and we were able to compensate the strong reduction of COVID with organic growth of approximately 2%.
And we have strong levers to continue the growth of that, compensating this reduction of COVID, which you are already projecting, plus reductions to try and do sustainable growth in the long term with strategic investments, as we mentioned here in Alta, in the capacity of services in some brands and in service units as we see in the market.
Thank you very much. "How have you accompanied our market share numbers? Do you do internal in-house research? How have you been accompanying our market share numbers?"
We have several sources. We look a lot at the IMS data, which helps us to do a comparison of expenses with diagnostics versus revenue, which we have. We also have data from our users.
The INSS expenses sometimes takes a while to come out, so we look at the growth of users by city and calculate the recurrence of exams and consultations, and then we evaluate how our market share is by city, by market. Then we have the picture of COVID overall and our participation in COVID. These are the principal numbers that we bring. We have a very robust market intelligence, which helps us to accompany the market very closely.
Thank you very much, Lucchesi. Very clear.
Continuing. Next question is from Rafael, buy-side analyst from BNY Investments. Please turn on your audio so you can continue. Go ahead, Rafael.
Can you hear me okay? First of all, congratulations on the results. I wanted to know a little bit more about the oncology front.
What are the principal perspectives that you have for the next few years, and what does the company have in mind in terms of strategy? And what do you consider your exchanges in oncology that we have seen in recent periods? I also wanted to know if you have any difficulty in re-passing these prices, if you have any accumulated demand since the pandemic, and if you could explain that to us, any changes in that area.
Rafael, thank you for the question. Oncology, Rafael, is very strategic in our business for two reasons. One, oncology diseases have a period of growth. There is a tendency that they will grow, and which is relevant. Secondly, because this totally fits with our strategy and our ecosystem of care. The early diagnosis of oncology has an impact on the total cost of this patient, which lowers the cost and generates a better solution.
It is totally aligned with our strategy. We consider this in the strategic vision that you mentioned, oncology as one of the high growth businesses of the company. These are the numbers that we accompany of growth in this business here in the company. The question of talent, we made the acquisition of AMO in the northeast. It was a sensational company. Very good people. Nelson, the CEO, is today the head of our operations in oncology for all of Brazil. We see that in the acquisitions. We also are seeking a medical leader in Brazil. Gustavo is one of the most renowned oncologists in and out of Brazil, ex-president of the Brazilian Society of Oncology. He is a medical reference, which we have been seeking, remembering that this business is what gives us focus for the last few years, looking for this leadership.
We are well positioned now. We are growing. We are the third largest player already in Brazil in oncology with exceptional talents heading up the business. It is very aligned with our strategy of navigation, early diagnosis, treatment, early treatment, and better results.
Thank you.
The question-and-answer period is now ending. I would like now to pass this over to the final considerations of the company.
Thank you. Thank you very much for having connected with our call. We are here very animated and enthusiastic about the possibilities going forward in the company. We are very dedicated to capture them in the second half of the year. Thank you very much and a good weekend for all of you. Thank you.
The video conference of results of the second quarter of 2022 of Dasa is now closed. The IR relationship area is ready to answer any other questions you might have.
Thank you to the participants, and have a good afternoon.