Better-Managed Hospitals in Brazil Offer Remedy to Thousands

Supported by IFC, Rede d’Or is offering specialized care and advanced medical technology to underserved areas of Brazil. © Rede d’Or 

When illness forced thirty-four-year-old Fabiana Ebani—a Brazilian nurse, wife, and mother—to quit her job, she sought answers from all the doctors she knew. But her diagnosis of severe cardiomyopathy, a form of heart disease, was only the beginning of her medical ordeal.

Fabiana Ebani received a heart
transplant at one of Rede d’Or’s
hospitals. © Rede d’Or

Ebani needed a heart transplant to survive. So in March 2016, she traveled 200 kilometers from her home in Macaé to Rio de Janeiro to be hospitalized at CopaStar. No heart was immediately available, and her condition deteriorated; at one point, she suffered six heart attacks in a 24-hour period. To keep her alive, CopaStar’s medical team connected her to an artificial heart for 53 days. The prolonged use of this technology, and the care of the hospital’s highly trained specialists, helped Elbani survive until her eventual—successful—heart transplant.

At that time, CopaStar was a relatively new facility—and the only local hospital in the state that could address complex medical conditions. A husband and wife (both medical doctors) founded Rede d’Or, the hospital’s holding company, 41 years ago, specifically to provide advanced care administered by highly qualified professionals in areas traditionally lacking good hospitals. Now, Rede d’Or is a network of hospitals and the largest independent operator of hospitals in Brazil, with 37 hospitals and 5,200 operational beds.

Since 2010, IFC has provided Rede d’Or with over $500 million of financing—including $285 million mobilized from other investors—so it could add hospital beds and expand the network, with an eye toward providing specialized care and advanced medical technology to underserved areas. The company continues to expand to better serve the needs of Brazilians.


A Holistic Approach

Brazil’s health-care system faces challenges. There is a persistent deficit in hospital beds nationwide, and quality can be poor. Although universal health care exists, the public sector does not have the financial resources to provide high-quality services for a population of nearly 210 million people. With a rapidly aging population and rising instances of non-communicable diseases, the demand for hospital services continues to grow. But a lack of scale makes it difficult for many hospitals to control costs—and limits investment opportunities.

Rede d’Or’s approach to expanding its network targets this problem. In addition to opening new hospitals, the company acquires struggling hospitals, preventing them from shutting down.  Rede d’Or invests in them and reorganizes them into better-managed, more sustainable care providers that can benefit from the purchasing power of the overall group.

Rede d’Or also works with insurance companies to control the growing cost of health care. This gives access to quality hospital services to a broader segment of the Brazilian society, including lower-income workers who previously didn’t have widespread access to health coverage.

The availability of health insurance has boosted patient volumes. For example, in 2016 Rede d’Or’s emergency rooms attended to 3.35 million people and one hospital alone saw nearly 300,000 patients. Quality has not been compromised with growth: five hospitals are certified by the Joint Commission International (JCI), and 25 hospitals are certified either by Canadian or Brazilian organizations.


Sharing Know-How

Research opportunities for its fast-growing cadre of medical professionals help the Rede d’Or network attract top physicians, who can pursue this path through Rede d’Or’s Institute for Research and Education D’Or. The Institute has received international attention for groundbreaking research discovering the link between Zika virus and microcephaly. Opportunities for further breakthroughs and training of top professionals will continue when the Institute opens a School of Medicine in 2019.

On the corporate side, Rede d’Or continues to expand. As of October 2017, it had acquired a total of 27 hospitals and introduced 10 greenfield hospitals, which have high- and medium-complexity capabilities. In addition, it has 35 oncology clinics. By 2021, Rede d’Or plans to add 20 more hospitals, offering over 3,000 new beds.

IFC’s role in Rede d’Or’s growth is not limited to loans. IFC acts as a sounding board for strategies, and our experience and expertise in health-care markets around the world plays a role in corporate decision-making.

Fabiana Ebani, who received the heart transplant at the Rede d’Or’s CopaStar, is relieved to no longer be one of the hospital’s challenging cases. After her surgery, she spent three days in the Intensive Care Unit. Later, she began rehabilitation with the hospital’s physiotherapy and other specialist units, which coordinated their efforts to focus on her recovery. Their teamwork helped her regain her strength.

“I was given the best assistance, not only in quality but also in the warmth of care from the medical team,” she says.

Learn more about Rede d’Or in the report Creating the Largest Hospital Network in Brazil.

To read more about IFC’s work in health care, visit

Follow the conversation: #IFCimpact

Published in February 2018.


Learn more about Impact at IFC:

View All Stories of Impact