Good morning, ladies and gentlemen. Welcome to the earnings call for the First Quarter of 2025 for the Mater Dei de Saúde. I'm with José Henrique Salvador, CEO, Rafael Cordeiro, our CFO and Director of Investor Relations. This video conference is being recorded and will be made available on the website for investors of the company after it's finished. To activate simultaneous translation, click on the icon of the globe on the bottom. All of the presentation will be available on our website in the section of Investor Relations. There is a disclaimer: any declarations that we have said in this call are related to uncertainties and situations that are unpredictable, things that are unexpected. The things that we say are related to what we see today at this moment in which we are having the call.
Any questions and answers will be at the end of the meeting, and you can also send questions through chat. I'm going to pass the floor to José Henrique to begin the presentation.
Good morning to all. It is a pleasure to be here with you today to be able to carry out the earnings result for the First Quarter of 2025. This was a quarter of recovery in many elements and fundaments of our company. We will have the opportunity to go over each one of these elements that helped us have a quarter that was much better and much better performance to the one we reported in relation to the results of the Fourth Quarter of 2024. Starting out with revenue during this quarter, and the numbers that we will present here are all numbers that exclude the participation of the hospitals from the network Mater Dei .
In this quarter, we had the largest net quarterly revenue, BRL 25.3 million in this quarter, with a very healthy composition of revenue. In this quarter, we also presented the best average ticket from our historical series, BRL 2.6 million per bed, reflecting a better mix of specialties in our institutions, a better mix of operators, and a better relationship, demonstrating better relationships with the operators of the network Mater Dei, with the capacity to incorporate price transfers in our tickets, our average tickets, and increasing our revenue through this pathway. This happened even through a period of unfavorable seasonality, different than what happened in the first quarter of the year 2024. This was a quarter where we did not have the impact of breathing or airborne diseases.
We did not have the impact of dengue like we had a very strong impact in the first quarter of last year, reflecting the capacity of the company to advance in our revenues despite all of that, and advance in surgeries in our services to more complex patients and clinical patients. Even with a high number of holidays, we had Carnival, we had Easter, and increased the revenue during this time. We are going through more respiratory diseases in the end of April, beginning of May. Now we are seeing a higher impact of that in our regions. This is also a quarter where we were able to demonstrate our capacity to bring operational efficiency that was even better for our operations. We were able to maintain our hospitals at an occupation rate of 80%, incorporating the concept of GIA patients or day patients.
With this, we were able to dilute our costs better. We started to present during this quarter a normalization, for example, of our costs with employees after the incorporation of the costs with the PL of nurses. Now our capacity is to dilute costs, be they with working force or inputs during this quarter. We were also able to present a higher dilution of our costs and expenses, especially in the extensive and deep work that has been done after the exit of Hospital Português. We have brought the company and the size of the company to grow even without that hospital. The result of this work, or the beginning of the result of this work, we are being able to present now in this last quarter.
When we talk about the reflection of the revenue, of this healthy revenue and the operational efficiency, it's also reflecting our margin results. It continues to be the same even with an unfavorable seasonality. We had, in this period, a growth of 3.4 percentage points in relation to the last quarter of last year. This result was the best in four quarters and also the best over the average that was presented in 2024. In this sense, we have a few highlights that are very positive highlights. I would like to highlight mainly the maturing and nurturing of some of our units. If we were to look at what has happened in Salvador, for example, Salvador has been able to present expressive growth both for revenue as well as for margin, contributing positively for the margin of the company.
There's 16% in the growth of net revenue in the Quarter of 2025 in relation to what was presented in Salvador in the first Quarter of 2024. It's the largest EBITDA of the last four quarters and the best net revenue from Salvador. When we go into some acquired units, we also see results of the work being reflected in margins and being reflected in growth. For example, the Hospital Santa Joana of Aveiro, Berlinger, had the largest EBITDA ever since the Second Quarter of 2023. We also had the highest average ticket in the history of EMEC reflected in the reality of the hospital and a clear tendency with Santa Clara with the services of robotics. We started to implement robotic technology in Santa Clara, and then we had a record with the number of births.
As was already mentioned in the previous quarter's call, it has been a very positive surprise for the Mater Dei network, and it has been a unit that has contributed to the positive EBITDA for our institution. Besides that, I would like to highlight that in this quarter, we were able to demonstrate our capacity to improve the cash generation. On one quarter, we had a cash flow that was positive with important improvements in our working capital. Rafael is going to talk about that soon, of making it possible for us to buy back some shares in a healthy position, cash flow position of the company, and making the company more and more comfortable in terms of capital structure and also in terms of our debt. Moving forward, we also approved in the company, given the more comfortable cash scenario that we have, an extraordinary distribution of dividends.
They were BRL 25.3 million to be distributed, which is around BRL 0.0745 per share with a payment foreseen until the 31st of May 2025. We are going to disclose more details on the distribution of the dividends as a way to value our shareholders and making it evident that our company has financial health. Another point that is very important is that we also had during this period the reaffirmation of the rating by Fitch, reaffirming our positive rating, showing our resilience in operational cash flow. Another point that is very important, this expectation and this maintenance of our network incorporates the expectation of maturing of our hospital assets.
Through this reaffirmation, we see an external environment bringing this support on what has happened into our financial economic results in each of our units, especially the units that bring disproportionate value to the company in the next few months. We also wanted to highlight the A3Data as a new solution of artificial intelligence. We released a case recently with Grupo Alfa with direct contact of more than BRL 100 million from the group's revenue in the last three months. This has been an important partner in the Rede Mater Dei and building products and solutions, which have helped the network Mater Dei and also other companies and will definitely help us even more, especially when we look at our cycle, our financial cycle, and everything that we can do to make the company more and more healthy and more and more ready for the next challenges.
It was a quarter, in summary, in which we were able to show the improvements of our results of quarter. We were able to show expectations in relation to the maturing of each one of our units, and that's already reflected. Even though there was a period of lower seasonality, more unfavorable, we were able to present a positive result for the company. This is what I wanted to share, and now I'll pass the floor to my colleague so he can talk about all of our financial indicators and how we were able to perform in this First Quarter.
Thank you, José Henrique. Good morning, everyone. I'll start on the page on operational highlights, highlighting some of the fundamental anchors for us reaching our goals of the year that were fundamental for us to reach the results of this quarter, which is our occupation rate.
We went back to having 80% considering the GIA patients, which is the goal number that we have. Of course, we can sometimes pass this new number. We do not have full control over it since it is something that is very alive. Reaching these goals is very important for us to control our operational costs. This is the second number of the series of five quarters. It is the only one where we had a higher occupation rate. It was during the dengue period. This quarter is a quarter where our occupation rate, we had an admission of 21 beds, but it was adequate to what we had in terms of demand in the quarter.
Going below on the slide, we had a drop of 0.7% in the number of GIA quarters, but we had a growth, a significant growth of 3.1 in the average ticket of the GIA patients, so from seven to 17. That compensated a lot. On the next page, highlighting the revenue, I'm going to continue talking about the ticket. It's the third quarter, the third quarter where we have expressive growth in the average ticket, growing 14 from and plus three. We were able to grow first 6%, and then we were able to grow 3% first to reach this result, which is a year-over-year increase of 14%. It was a lot of discipline that we had to have to make adjustments on the right dates.
We've had a relationship with the operators that has been much better, which in the past was not so great, but now we have a relationship that always needs to be worked on every day. We no longer are under that desperation that we had with the operators. The new hospital in Nova Lima and Salvador are hospitals with higher average tickets, which are supporting us in the almost BRL 4 million of used beds. In the first quarter, we're very attentive. We're paying a lot of attention to the access to surgeries, and we are working on this. We still have possibilities of having much more recovery. I would also like to highlight the focus of the company on revenues that do not include the beds.
We have a lot of revenue from the patients that are doing imaging and cancer patients, and these patients are fundamental for the growth of our revenue. Going to the revenue on the bottom of the right side of the graph, we had the best revenue, BRL 500,000,000 of net revenue in this quarter, growth of BRL 2,000,000 against the last quarter, which represents a growth of 2%. All of the improvements are reflected in this improvement of our revenue. In relation to costs and expenses, here we have a lot of learning where we talked about this in the last call. It does not reflect we were not satisfied with the results from last quarter, and we wanted to improve that. Things did not happen immediately.
We had to make a few top-down actions, and that was reducing our workforce, and that is now being resulted in this first quarter. On the next quarter, we will see more results of the work that we made because in March and April, we are still carrying a bit of the cost of the emissions of the work that we did. Macho Maggie had an important reduction in the new mix that the company has working in negotiating with suppliers. We had 71.2% with BRL 356 million, and 25 is not better than the first year. In the first quarter of 2024, we had two items that helped us in the result. At the time, there was a reversion of BRL 3 million in a PLL, and the other was mainly for comparative issues.
The first quarter of 2025 has the full infirmary, and 2024 was the composition of the first parcels, and it was only BRL 3 million. If we look at these differences in the first quarter against the second quarter of 2025, it is more expressive because of the numbers that we are showing here. In relation to the cost, operational costs, there was a reduction of 1.1 going to 14.9, a number that is still high but is still very healthy. Here is the constant work of improvements that we have that dilutes with the entry of new quarters with higher occupation rates and higher use of our hospitals and more seasonality. These numbers will probably drop, but this number was the result of the work of cutting down some operational costs.
Going to the next slide, our EBITDA slide, we have this classification as adjusted EBITDA because the third quarter of last year, we had an adjustment of several situations and of Nova Lima. In order to make it comparable, we are using the terminology of adjusted EBITDA, but this year, there was no adjustment. We do not comment on that anymore, but within the BRL 97 million, there was an expense of stock options of a program, which probably will not be executed again because of the incidence of the program, but it is accounted for. It is also important to remember that we do not adjust this in our results. We had BRL 97 million, a growth of 3.4 percentage points, which comes from the reduction of costs and expenses that I mentioned.
The historical series just shows how in the first quarter of last year, we had the seasonality of dengue, and we did not have the infirmary yet. If we were to look at the average of the year of 2024 in our EBITDA margin, the company did 18.6. We are 0.6 points better in this year, higher than the average of last year, which puts us in a position of a possibility to improve the results over the year. Going on to the next page, working capital and net profit, we can highlight two images with the adjustments because now we do not have this adjustment anymore. We would like to show what is the margin of the company disconsidering the premium.
Looking at the full numbers, we had 4% of profit of BRL 12 million higher than the fourth quarter that had a margin when compared to the margin of last year of four. It was 1.7. We had a higher margin than the second quarter of 2024. This is a recovery that we had. We are halfway to recover this margin, which is one of our main objectives for this year. In the reflective of cash, it was BRL 20.9 million. Since we do not have the premium anymore, there are various actions that we will carry out over the year for us to diminish this because the controller and payer of debts, if we do not have these mechanisms, as these other controls, we will have more work. We are working very hard on this.
It's an important point in order for us to reach better cash flow. The MRP and PNPME, we had an anticipated purchase of some medication. This is affecting our stock for a short period, and over time, this will normalize. There is an increase of the time with our suppliers for the same reason. In the PME, we had an average of four days, half of them because of the growth of the suppliers in the first quarter. The others are occurrences that we received. We received two anticipated deals because of regulatory issues that they had, and that was able to help the result of December. The comparison is not so good because of that, but we noticed more stability in our cycle of revenue. We have a cycle that's much more mature in which we'll be able to control the working capital much better.
Going on to the next page, cash flow and debt. Here we have good news. We were very satisfied with these results. We were able to lower our net debt in BRL 1 million if we lowered the purchase of shares, which was BRL 11 million. When we rebought them, we had BRL 1 million positive. This shows cash control or cash generation and working capital that is one of the focuses of the management at this time. We had a working capital consumption of BRL 19 million. It is the second best number of our series of the last five quarters. This shows strong work on all points on stock and inputs in the flow of payments. Another line to highlight, and it is important to mention, is the control of CapEx. We had BRL 34 million in investment. BRL 13 million were from investments that we normally have in maintenance and expansion.
In this case, ours are more intangible because they're maintenance. We have a lot of investment that is paralyzed to bring in new revenue. We did Nova Lima, Salvador. This is the year of making the company profitable and spending more in CapEx. The other line that was very important to highlight was the issue of the income tax, which we paid BRL 3 million, much lower than is our usual amount. We had a rate of 23% instead of 24%. Our cash flow closed with BRL 7 million, which was on the higher part of the page. We have 1.6 of net debt for the last 12 months. The debt, as I mentioned, of 1.64 with a cash of BRL 260, which brings a net revenue of BRL 781.
Program of finance, we continue with a comfortable schedule with the average timeline of four years with lower rates of CDI. The financial situation of the company is a situation that has been improving. It is already a situation in which our sector in the Brazilian market is very comfortable, but we did not remove, and it will be the focus along with the increase of profitability of the company. We will work very hard with cash flow to generate cash and control costs and control investments. That is the end of my presentation. We will open to answers and questions. Thank you very much.
The first question is from Gustavo Quiseo.
Good morning. Thank you for the opportunity to participate in this call. First, we would like to talk about the perspective of margins. You already said that there are several factors that you are working on to improve.
What is your perspective for the end of the year or over the year? What are the main lines? You talked about workforce. You talked about dilution of the impact of the infirmaries. If you could give us a timeline for us to understand a bit better. The other point on the operational beds. Since you removed some from Hospital Português, it has been dropping no matter how many assets that you have that are ramping up. It is just to understand if you are focusing on profitability or what is against you there. Are they the new acquisitions that you are closing? Because last year, you were closing some beds, or they are mature beds that are offsetting Nova Lima or Vejo Fantasia and Salvador. Just so we can try to understand this dynamic a bit better. Thank you.
Echezeo, good morning. Thank you much.
Thank you for those questions. I'm going to start with your second question. In relation to the operational beds, what we have done in our work here at the company, and this is something that we bring every quarter, quarter over quarter, because this is an important point for us to work on in our profitability. The maintenance of our occupation rate is a work that we do also to reduce the average rate of permanency of the Rede Mater Dei so we can bring more reduction of costs and a relation that is much more healthy with the operators. It is for us to be able to work and make more efficient our diverse hospitals so that the hospitals can be profitable, so they can grow with sustainability, and they can also be healthy.
We have tried to more and more share this with you and unanchor the growth of revenue or perspective of growth of volume to other variables that interfere with that, such as a mix of services, complexities, readjustments as well, revenues that are complementary services such as the emergency services. What explains better what is happening in terms of the number of beds is especially this vision and this efficiency that we want to give to the company so that we can reach and improve our margin numbers more and more. We get into your first question. As I said previously, we started the year in January with a negative seasonality.
There was a month in which we had the impact of movement that impacted our margin, and then we had a February and a March that were very affected by all this positive work that we've done. It is an expressive improvement in the margin, and we hope that this continues month over month with a very clear vision on what are the bases and foundations that include costs and expenses in the company, a very detailed control in each one of our hospitals for all of these variables, and also a capacity of incorporating more revenue in each one of our new units. All the units of the network Mater Dei have been able to grow their revenue in a normal way without any seasonal events that appear.
This brings to the company a capacity to increase margins quarter over quarter, reaching the end of the year with those margin levels that we presented in the past, with a very good perspective of improvements also through the growth of our new units.
Perfect. Thank you so much.
Next question from Vinicius Figueiredo of Itaú BBA.
Good morning, everyone. Thank you for taking my question. The first topic that I wanted to explore is about accounts payable. If you can explore what has been done in relation to that, we observed that after Hospital Português, you had some relief. When we look at the dynamic from the fourth quarter to the first quarter, we would imagine that there would even be more expressive improvement because of the mix of payers.
Maybe you could explain a little bit more what we should expect looking into the future on the specific line, if it should be something that will help the cycle of conversion over the year. Another point that I think you even explored a bit. It's important that you put the disclosure on the release in relation to the growth of the Salvador hospital specifically. If you could speak specifically on how this has evolved in relation to management and the ticket, and how much this evolution of that ticket is composed of volume and how much is of ticket. If you could give us a better idea if this will already be a detractor in the margin, I think this will help us understand better.
Thank you. Vinícius, good morning. How are you? About accounts payable, we have accounts receivable.
We have been discussing this for some quarters. We suffered initially a lot with the change in the dynamic. We had the operators making them work much harder than we made them work last year with some mechanisms. What we noticed on our end, which we are operating in these two fronts, the first is to not let the discussions on gloss accumulate so much when you are discussing more distant periods when there are clients that leave the base, and then the loss comes into the discussion, and it is a discussion that is not so great. This process is fundamental, and we have re-adequated our way of working with the way of approaching the operators.
The second issue was an issue that took a little longer, but that we are almost finalizing in this aspect, which was to regularize some contracts, some contracts and understandings, and the way that the day-to-day relationship with the operators is built. This is one part, like Egeia, in which we have clarified some points, especially with new markets being open. Even if they are the same operators, they have different rules, but we were applying the same rules. We have worked on that. There is also the growth of the unit in Salvador and Nova Lima. There is an increase of working capital from those units. The composition of our revenue also changed a bit, and there is that extension.
We had these purchases, these purchases that were bought in advance that unbalances things a bit, but it's not a loss in the quality of our accounts receivable. What we have this year are a few important agreements which we made with the operators of things of the past, which we believe will be reflected more towards the end of the year. Part of that we had in the first quarter, but most of it will appear in the next quarters, which will improve these numbers for us to finalize accounts payable, to even impress our final numbers. All of this is in the strategy of our company, and we hope to have improvement in all of those lines.
I'll answer the rest, Vinícius. Good morning.
In order to also talk about Salvador and your question about Salvador, we had in Salvador last year, we brought this news in other conversations on results, but also in our conference calls, some updates that were important in Salvador, especially those related to credentials. We had large operators in the cities that registered some products, and this has supported the company in a positive way, improving our mix of partnerships in the units. The main focus of the action in Salvador, which is something that we have also repeated a lot, is our capacity to evolve more and more in the quality of the operation. The structure is something differential that we have in the city.
The quality of the units has only improved when we look at our indexes of satisfaction of our clients, especially the NPS of the units have been excellent NPSs, which we have compared to our more mature units. The indexes and the perspectives of excellence within the categories of NPS, and also a lot of work for relationship and attracting reference medical teams in the markets. These are teams coming in from other institutions, and they are reinforcing the medical body of our units. With that, they are making sure that the unit can be more preferential for the operators, which understand our model. Once again, as a win-win situation, a sustainable model, which has sent more patients to their units, and also doctors that recognize the quality of those teams have also incorporated our clinical bodies of the units.
This has reflected a higher number of patients, a higher search for patients, even notorious patients who look for our units more and more. This has reflected in the unproportionate growth of revenue and a positive incorporation of margin. When I said January was a month that was also seasonal for Salvador, we see these numbers also reflected from Carnival, which we know also has seasonality. We are very content with the way Salvador started the year of 2025, with a margin that was already reported by the unit by the level of revenue that this unit is representing. I have no doubt that 2025 will be an even more transformational year of even more growth of revenue and margin for that unit.
Thank you so much, José Henrique. Thank you, Rafael. Thank you.
The next question is from Mr. Samuel Alves from BTG Pactual.
Good morning, José Henrique.
I will start talking about occupation we had in the month of March. High occupation, as we mentioned. It is natural that we have growth month over month when we leave the first quarter. We always have the second, third quarter that are stronger as well. It is what we start to observe. We had an April of high occupation, high volume, and May also is a month that has started well in terms of demand, as once again, the components of respiratory diseases for this period. I do not know if that has happened in something that is happening in the entire country of Brazil. We have a lot of discipline to maintain these occupation rates, also with opening more beds in this period because of the increase in volume.
We are accompanying this very closely so that we can do everything to keep the company growing as it must. With that, I will pass to Rafael the second question. Rafael,
thank you for that question. Let's just go back a bit. Last year, until the third quarter, we were using the premium 100% of it. We would take advantage of it every month and would be adjusted. In the last quarter, we changed that. The loss of the year was not taken into account. Because of the exit of Hospital Português, we would use it as also 100%. This year, what has happened? The loss of Hospital Português or the sale of Hospital Português generated a fiscal loss to us. Within the rate that we paid of BRL 3 million, which we disclosed in our cash flow, it generated a 30% indebtedness, which generated that fiscal loss.
We were able to take advantage of 30% of the profit. We are going to use the profit of 105, and we are going to use other things in the company to change this. Nothing has changed. Before, we would take advantage of 100%, and now we have a more limited use of that premium.
That was clear. Thank you, everyone. Good morning.
Next question is from Thalys Zanon from JPMorgan.
Hello, everyone. Thank you for taking my question. The first one is about Nova Lima. Maybe if you can talk about the ramp-up of that and how are the conversations going with the payers in relation to credentials and also the clinical bodies. Another point that I wanted to explore is the agreement with Unimed Uberlândia that you announced in the second quarter.
Do you believe that there will be an incremental growth like you saw in the first quarter? What are the expectations from now and for the rest of the year?
Marcela, good morning. How are you? Thank you so much for that question. Starting with Nova Lima, in relation to what we have seen in the unit, as we said, it was one of the units that in Rede Mater Dei had a faster operational break even that improved our margin with growing revenue, but the margin grew month over month, mainly because it is a unit that concentrates an average ticket that is higher because of the mix of operators that are there and also because the mix of the unit. It is a unit that is eminently surgical that has a quick turnover.
Like in Belo Horizonte, we were able to have a smaller administrative support, which helps us to dilute the fixed costs that exist here in the Metropolitan Region of Belo Horizonte. It has been very important as well in this sense. Besides bringing in a new concept of service, a concept that is being very well accepted by that population, the credentials evolved very quickly. We have in the credentials of the main operators, which we seek after in order to credential them in the unit. We are missing just one operator that has a number of expressive lives here in the metropolitan region with high management. We are finalizing the credentials with them for them to be part of Mater Dei Network. That's something that we've been working with them. The clinical body is the same.
We have been very strategic in the kind and profile of the doctors that we are attracting to this unit, taking advantage of opportunities to bring in new doctors and teams that we always wanted. When we have a new unit, we always present a new opportunity of building new relationships with some of the teams, maintaining those more strategic ones for the Rede Mater Dei de Saúde Network. In relation to Uberlândia, as we mentioned here in the beginning of our speech, we had the growth of revenue and margin in both of our units. We incorporated technology and we incorporated new services in the units of Uberlândia, and that was anchored on an agreement that was made, reinforcing our relationship with the main local operator. They also saw us as preferential.
The first quarter is still very recent in relation to the period in which we signed the agreement, but already with signs of some new patients in the child and mother section. If you remember what we presented, we are contemplated as a reference hospital for the children's line in Unimed Uberlândia. We also are a reference for the elderly. We have received more patients, oncological patients through this partnership. What we see there is a positive perspective in that this operational agreement will bring to it. It is still in the beginning, but it will incorporate more revenue and margin for the network.
Thank you very much. That was clear.
The next question is from Caio Moscardini from Santander.
Hello, everyone. Good morning. Thank you for taking my questions.
I would like to know what the average of credentials are with Hapvida and Lima, how you advanced in this subject, and what is the relevance of lives not in beds in relation to the margins for this kind of revenue in relation to the margins that you generate?
Caio, thank you for those questions. There was no evolution in this quarter in terms of new credentialing in Hapvida and Salvador. We have in the Metropolitan Region of Belo Horizonte, our hospital, Santo Agostinho, and Queen Contágio being credentialed by Hapvida. We did not advance in the Hospital de Lima in Recife. In relation to the revenues outside of the beds, I am going to let my colleague complement in the end.
Just for you to know, our vision about this, Caio, is that the hospital units bring a lot of opportunities for us to work in chains or in journeys. What we observe is that the patients that look for us, they have an opportunity through these lines of care to be part of a real ecosystem. We want to be positioned as hospitals that have high resolution for various demands of the patient, be it in primary, secondary care, or tertiary care. The patient ends up doing several exams in our structures, and we are able to incorporate technologies and resources from diagnostic technologies. It is one of the most important vectors of growth that we have, and we have invested a lot in that. We will have a lot of good new things to present over the next few months in relation to oncology.
These revenues and incorporating the needs of the patients, and they incorporate especially them when we look at our average tickets, contributing to the answer of Zahinkipi to help you out. I think there are two companies in the sector that are specialists in the revenues outside of beds. You know the profitability of, for example, the two revenues that are outside of beds. Speaking in terms of margins, from the point of view of the company, we work a lot on this issue outside of bed, not because our strategy is changing, but more to help you is to not make projections of the PDNA only in the growth of adjustments for beds. We go with this work, as Zahinkipi mentioned.
We have a complete service to our patients, and we have the possibility to grow our revenue with the general revenue of the company without needing to open more beds. We also have several initiatives using artificial intelligence. We highlighted this in the beginning. Oh, I also forgot to answer this underneath this question. We have our inner cycle of revenue with working with AI if revenue as a whole. Yesterday, we were talking internally, and we had a tool in which one patient of ours here, we are not talking about increasing the needs of the patient. We are trying to avoid the exit of revenue from our hospital. We have a robotic tool in which if someone comes into our hospital and needs an exam, they can come in and do it quickly.
Through their cell phones or WhatsApp, they can receive a notification, and we offer different dates. These are tools to increase revenue with what we already have in-house. That is what we were wanting to highlight in this sense. Was that clear?
Yes, that was very clear. Thank you. Great weekend.
Next question is from Tadeo Matuda from Tilden Capital.
Zahinkipi, Rafael, thank you for answering my question. It's a pleasure to speak to you. From all of the points that were addressed here, they were very interesting. One of the things that we've discussed and that is very interesting in the dynamic of Salvador that you brought us, just an adjustment of perception very quickly. When you think about the cycle of the historical maturity of your units, what do you see for Salvador and for Nova Lima?
How do you have the perspective of this maturity from these two units specifically going through the mix that you expect? Thank you.
Adéodato, I'll start answering. Thank you so much for the question, and thank you for the interest. They are two very different units, be it through the profile of the location, Nova Lima's unit that takes advantage of the structure that already exists in the Metropolitan Region of Belo Horizonte, and it also ends up taking advantage of the existing relations in the Metropolitan Region of Belo Horizonte. We were able to build for 45 years a relationship with doctors, with politicians, with the market itself. For Nova Lima, it was much easier to be able to incorporate these relationships in the day-to-day of the unit.
That is why we saw a unit that grew in record time, not more quickly than Salvador, but then faster than other units that we may have already opened in the region because of those characteristics and the concept. That is how the concept was implemented. Salvador was a unit in a new city. In other words, in a market to be developed with new relationships to be built as well. The most important thing about Salvador is that we went through that period of having to prove our characteristics and prove our model. We learned a lot, obviously, with these units in the first year and a half, two years of functioning. In this year, we will be closing the third year in May with a year of growth, be it in revenue or in margins.
When we look at what's happening now with growth month after month and week after week with new teams coming closer to the unit more and more, we see how much this unit more and more will incorporate more revenue and margin for us. The incorporation of Salvador at this moment is disproportionate, not because of the size, but we have seen expressive growth in oncology, for example, in that unit in complex surgeries. It is a large market in terms of numbers of lives in Salvador. The ramp-up for the operational efficiency has already happened. We start to incorporate margins to improve the state of the company. Just to complement what José Henrique mentioned, for us to be successful in the markets that we are in and we choose very carefully where we want to be, we need to have relevance or connection in the region.
These sequences of M&As helped us learn some things in the process that it is not just open and spread growth everywhere and say that you are a national company. You have to be represented in terms of operations, but you need to have a local DNA where you have a regional brand. Otherwise, you see that it is the character, you lose your characteristics. Nova Lima is the continuity of a class that we are leaders in Belo Horizonte, and we want to continue to be leaders for a long time. We have charts to dilute costs. We have a small amount of units that we have, and now we will have more and more in other revenues, oncology and surgery. Speaking about Salvador, we have occupied a space where we have not taken space from anyone.
We are occupying some of the hospitals that got weakened in the process in Salvador, and we were able to be a hospital for the population of Salvador. Last week, we received, for example, a very special patient in our hospital that posted on the social media, which shows how we have the face of Salvador, and that's our objective. We will continue to grow, creating this DNA. We were able to, and they got to do that in the last 45 years, and we are continuing to do that. When that happens, that can solidify your brand. We are very satisfied with the growth, and it will be fundamental for the results, both of the size of EBITDA as well as the composition of margin for the network Mater Dei. Just to finish completing this response, there's a very important point about Salvador.
We are at a moment in which we have been able to make studies and complement operational efficiency. Adéodato, we need to treat well our beds to have high impasses and to have a very close relationship with the clinical body of that unit and bring that clinical body into the importance that they have so that they have the light that they need in order to have quality equipment and to develop their potential in that market. The clinical body in Salvador is a very special clinical body.
Excellent points. Thank you so much. Soon we'll continue talking. Thank you so much.
Next question will be from Mr. Gustavo Mireni Gonçalves.
Hello, Zahinkipi. Rafael, thank you for the presentation. Two very quick follow-ups. The first one of them in one of the previous answers.
Zahinkipi commented about the velometry of April and May, and he said that the volumes apparently are already at a robust level. I just wanted to get more clarity on the comparison year over year with a high volume, higher than last year, especially for Belo Horizonte. If you could give us an amount of how much that represents for April and May of last year in terms of complexity, if it's better or worse, that would be interesting. As a second quick follow-up on the topic of the clinical body, I just wanted to understand better since you've made some expansions in regions where other companies also have made expansions. I imagine that the competition for the clinical bodies is very tough. Are there any financial challenges? Because retention and attraction of new doctors or physicians can end up affecting the costs.
What is the moment in your company right now? And how that can be offsetted in the future?
Yeah, Ajay, thank you so much for the question. First, in relation to volume, I think it's hard to conciliate these numbers. What I can say is the following. In the first quarter of 2024, it was a quarter that was very affected by dengue. We had, for some months in the first quarter of 2024, in one specific hospital, more than 800 patients that we had to bring in because of the epidemic of dengue, the worst one in our historical series. It was a period of the year where we had more stress.
What we can say is once we normalized those dengue services, we were able to grow on other lines, especially in the Metropolitan Region of Belo Horizonte, which were one of the main focuses of dengue. This perspective is very important, and it is, of course, a reflection that we make every day. At the rate in which things become clear, the clinical bodies in all of the markets that we are involved in, in our strategy of Mater Dei and in our format of relationship, in our format of positioning, it's a format of positioning where we attract a clinical body through a strategy. We give them opportunities to build. We do not restrict the activity of the doctors. They are not attracted because of payments that can unbalance or tantalize our relationship with them. That is not our positioning.
We want the doctors to be very well paid, and we will always help in that sense, but it's not how we attract them. It's not a format in which we create models that will privilege that transactional short-term construction. We want to have proficient long-term relationships with our doctors and have people that can stay with us for the long term. On the issue of the numbers, I think we can make an analysis of all of these situations we presented. We have 52 beds less than the first quarter with an average ticket that is 14% higher. We had a lower amount of patients in the company. We had more stress in the operation, which was temporary, that brought results that show we are also protected from any kind of epidemic in order to reach these good results as well.
It is not the kind of projection in which you can make comparisons. It is atypical, and I think the numbers show that we want to make the company profitable in terms of margin and EBITDA with more robust growth. We understand that we need to have the right growth to be able to make this grow.
Excellent. That was very clear, Rafael. Thank you.
The next question is from Somar Ozak from Verdisco.
Good morning, everyone. This is a question in relation to the Metropolitan Region of Belo Horizonte. If you could explore, how do you see the perspective of growth, excluding Nova Lima and these revenues, these recent inpatient services since it is a more mature region?
Thank you so much for that question. We do have that and important perspectives for growth.
Also, with opening new beds, as I said, I always need to go back to this issue for us to normalize the growth of the number of beds. We started last year with more seasonal growth and a seasonality that is well established for April and May. That is very clear to us here. Nova Lima, it is important that it is not disassociated from this strategy because a lot of the time the teams start with Nova Lima, but they also use the other units. For example, they use Nova Lima to be able to do one kind of surgery, but there is one thing happening in another unit. We are able to, through Nova Lima, also reinforce the relationships in our units.
We are working on, be it through budget or execution, so that each one of our units, be they Santo Agostinho, Contágio, or be it Mater Dei. Thank you.
We finished our list of questions and answers. Thank you, everyone. We are reaching the end. Thank you so much for those who reached us and spoke to us. Thank you, Rafael, and the team. Please send us any extra questions you may have if you have any questions from the company. Thank you so much. Thank you and have a good day.