Good morning, ladies and gentlemen, and welcome to the earnings call for the first quarter at Mater Dei. Today we have José Henrique Salvador, our CEO, and Rafael Cordeiro, our CFO and director for investor relations. This earnings call is being recorded and will be available on the investor relations website after the completion of this call. To activate the simultaneous translation, you can select the globe icon at the bottom. The presentation is available on the company's investor website. Before we continue, we'd like to let you know that statements about future events are subject to risks and uncertainties that could lead to non-completion of such expectations or differ materially. These forecasts are considering the moment when they're made and the date, and the company is not responsible for achieving them. After this, we'll, we'll have a Q&A session, and if you have any questions, please request through the Q&A action icon and we'll open up your mic. Or if you'd rather send by chat, please identify yourself. We're going to begin now with our presentation. Hi, guys. Good morning. It's a pleasure to be here. As we talk about the results and earnings at the Mater Dei network in the first quarter of 2024. To begin the presentation, I would like to remind you all that a period of a lot of lessons learned for all of us. In April 2024, we are celebrating three years ever since our IPO, the moment when we decided to have the public offering for the shares at Mater Dei. At that moment, we wanted to pursue our plan for growth organically and inorganically through acquisitions at that time and expand the Mater Dei network throughout the national territory. During this period, we had a lot of lessons learned, a lot of growth, and a lot of value creation for the Mater Dei network. It's important to mention that before the IPO, we were 524 beds, and we were based in only one state here in Minas Gerais in the metropolitan area of Belo Horizonte. Today, the Mater Dei network has 1,534 beds, and we're already present in four states, leaving the metropolitan area, and in two cities in Minas Gerais, but also in another three states that are very important and cities that are very important in our country. We grew our revenue during this period at a CAGR of 37% year-over-year, going from BRL 227 million in the first quarter of 2021, moving on to BRL 583 million in the first quarter of 2024. Our EBITDA, in the same way, grew at a CAGR of 31% year-over-year. We had, back then in 2021, in the first quarter, BRL 62 million. And in this quarter of 2024, we were able to reach a milestone of, BRL 140 million, one of the biggest levels of EBITDA we've ever achieved in the company. The Mater Dei units, despite the challenges in the sector, have, been able to achieve their objectives more and more as the greatest references in the communities they're in, with a lot to be built still, of course. But in the short term, we've observed some important achievements. Salvador has had significant growth in revenue and margins in this first quarter of 2024. This was a big differential for us, when it comes to gross revenue and margins. The Mater Dei Nova Lima will be open now in the second semester this year of 2024 with a really positive acceptance level among customers we've presented this project to. We are still very focused on opportunities to make our cash position more robust, and we're always assessing the best decisions when it comes to capital allocation. This is a constant process in the Mater Dei chain, understanding how we can allocate our capital in order to bring even more value to our investors. It's also important to mention, on the next slide, that this year of 2024, we celebrated five years ever since the inauguration of the Mater Dei Betim-Contagem. The Mater Dei Betim-Contagem is one of the main hospitals in our network, and it's a regional reference that services people in a certain specific region in Minas Gerais and today delivers complexity, access, and completeness for the services in that population. In five years in Betim-Contagem, we were able to achieve over 900,000 services. We went through two important accreditation cycles by Joint Commission International, the main certifying body in the world. And we've had constant growth every quarter, which makes this positive ramp-up quite evident and no doubt at all. But the Mater Dei in Betim-Contagem is most likely one of the main hospitals in our chain. We also want to bring the evolution in the execution of our strategy in partnership with A3Data. We are presenting two products, which is the Maria and Louvre. These are two products that are part of our portfolio, and they're being developed at A3Data, with the strategy to unite health and tech. We're going to be able to present to the market in the next few months, an important unleashing of this thesis with many customers that have been adhering to these platforms and a big opportunity for growth, with economic and financial services and value, but also strategic positioning that's more and more relevant, incorporating A3Data to the day-to-day activities of the company. We've also had, during this period, some important evolution when it comes to governance. In the first quarter of 2024, we were able to have the beginning of the work in our Finance and Investment Committees, our Committee for Quality and Care Practices, and also the Committee for Commercial Strategy. All of these committees have already been demonstrating to be a very important toolset to support the Mater Dei management and also support the evolution of our processes and bring along important people to help us really set the future of the Mater Dei network in the next few years. We can move on. Now, as we get into the financial status, we can also share the presentation with Rafael Cordeiro. He brings more details about our financial performance. In the first quarter of 2024, we had an all-time high in occupation rates. We grew 8.4 percentage points year-over-year in our levels of occupation, which made it very evident to understand the Mater Dei network team's capacity with our greater efficiency. We've also brought in some of our meetings and our earnings calls, our call, our internal calls so we can become more efficient. We can work with a higher occupation and really be able to support our levels of margins and grow our margin levels during this year. We can make this quite evident in the first quarter. In this quarter, we also had an all-time high when it comes to our net revenue. It was the biggest revenue in one quarter that the Mater Dei network was able to achieve. We demonstrate this in the first quarter of 2024. It was also one of our biggest EBITDAs in the company's history, with BRL 140 million in EBITDA this quarter. We continued with this. This EBITDA, these levels, demonstrates a healthy level of debt at stable levels that also positions us very positively in our sector. We continue to have a very important perspective. We've been looking at our capital allocation. No doubt, cash is king, and we are becoming even more focused at this moment. We're going to be very, we'll be able to have, opportunities to have more robust cash position and really have a year that's going to start off a lot healthier and prepare us for the next steps we want to take. 2024 is definitely going to start off in a very, interesting way for the Mater Dei network. And with this, I want to pass the phone to Rafael, so he can proceed with this. Well, good morning, everyone. Thank you, José Henrique for the presentation. We were able to end the first quarter very close to our last, release in the end of the year. But we've had, results that are a lot better than what we had in the fourth quarter last year. We mentioned that was really out of the curve or, and now we hope to reach a seasonality with better results during the year of 2024. So moving on to page six, we have been talking to all of you guys about the budget issue internally at the Mater Dei network, and we really know the importance to be able to achieve this better result from 2024 onwards, considering different aspects, especially when it comes to the nursing bill, where we have to operate with occupancy rates that are higher. So, of course, this 79.1% that we operated in the first quarter had a bit of an impact from dengue cases. But this is going to be an internal strategy also to have higher occupation because if we have higher occupation, we'll be able to reach the same revenue with a few less beds. With this, we'll be able to have a leaner team. The percentage of people, towards, as an, percentage of the costs became even more important in the sector. It's going to be a challenge during 2024 and 2026, 2025, sorry, to have the offset of this increase. We will be working a lot internally. This is going to lead to a bit of stress in our operations, but we'll be able to profitabilize the company a bit more. We'll keep the same level of beds in regards to last year. We had 13% more patients per day, so this occupation made us increase our revenue compared to last year. Even so, we were able to operate 17 beds less. That doesn't mean that the company's not searching for ways to open up new beds. But this opening is always going to be based on the increase of services in the hospitals and not only open up the beds and have a lower occupation rate. So this is going to be an important basis for the company from now on. So when we talk about patients per day, we reached 83.2, and both of the milestones were all-time highs, when it comes to occupation. So we had a growth, with about almost 10% in regards to the fourth quarter of 2023. So when we move on to page seven, we had a pretty stable ticket, in regards to 2019, and a drop of 4.6% in regards to the fourth quarter of 2023. But I want to remind you all that it's kind of a different profile compared to the first quarter. So maybe it's the hospital network that is most impacted by dengue. The first quarter of 2023 had a different kind of profile. So here, there's not really a concern when it comes to adjustments. Here it was really, really clear in regards to the profile. This is reflected a bit in the costs when we analyze this. We can notice a reduction of MatMed, because of dengue. So we had 11% and 8% growth compared to the fourth quarter of 2023. As José Henrique mentioned, we reached an all-time high revenue of BRL 583 million per quarter. So when we get into the dynamic for costs, and we reached 3 percentage points below what we had reached in the fourth quarter, which was a very frustrating quarter, as I mentioned. So we can have some more stability in regards to our costs in 2024. So we, we had an improvement from an operational perspective, but when we consider the profile, the margins in the first quarter of 2024 are still very much hindered. We're going to get into a bit more of this dynamic now when it comes to the working capital and the increase of provisions and other issues related to our costs. But operationally, we've had a quarter that's a lot better than what we had seen. Changing this trend was very important so that we could really understand the expectations for better results throughout the year. When it comes to expenses, we had a stability that's really interesting. We had a drop of 0.2 percentage points compared to the fourth quarter. But this is a really interesting point, which is the stability in regards to the first quarter of 2023, which is not related, considering the back-office expenses. But this is something we were able to do. When we look at the analysis, when it comes to provisions and NPL, we did have better operations this quarter when it comes to expenses. But our NPL was still, relatively, impacting our results with a bit of loss, with a very long tail, a chain. The improvements in the company and opportunities for improvement take a little while to actually demonstrate a clear perception of improvements. So there's still a big challenge when it comes to NPL. So when it comes to the costs, we can see a clear reduction in medical materials, which was very important for our reduction quarter-over-quarter. Another point also I would like to highlight is the medical services. We had some outliers in the fourth quarter, and this reduction comes from a strategy that the company had in 2023 to readjust their relationship with clinical teams. We're starting off with an increase of our revenue, really reaping the fruits for this new strategy so that we can have sustainability in the beds that have been opened and also bring in more patients to our organizations, really in line in units where we know there are operational beds to be opened with a big trend to increase this result over time. Moving on, the consequences of this improvement in the costs, because part of the expenses were offset in regards to the NPL, we had an improvement of the same percentage points. Here in regards to the fourth quarter, as we can notice, we went back to operating at the levels we were operating in the year of 2023, so about 24%. And we still have opportunities to improve these results over the years, but we can still demonstrate an important recovery in the credibility we've already, where we've always been one of the best or the best operator for hospital networks in Brazil. So we have a drop of 1.3 percentage points. But if you stabilize this situation in the NPL that's still high, but we believe will drop over the years, we would also be operating at the margins of the first quarter of 2023 with about 25% or maybe a little higher, which would get back to what we believe the company needs to fix. So when it comes to slide 10, we get we leave a bit of the economics and we get into the cash flow before we get into the net income. Just the results we improved in the EBITDA really reflected the net income, and we were able to have a financial result that was quite interesting with the reduction of the salary grade and also improved administration. We were able to bring 2.4 percentage points, and so we were reaching 11% of adjusted net income. We consider the adjustment of the non-recurring factors. When we only consider the goodwill, it doesn't get into our financial results, but it does have 100% effect in our cash flow. So as we mentioned, profitability, and we're talking about the conversion of our profit into cash, we believe that the best way to demonstrate these BRL 18 million is if we can adjust this, to really reflect this. BRL 64 million will go back to double digits in the net income, which is also a very interesting result in the company. So when it comes to the first quarter of 2023, where we had a better EBITDA margin, we were also able to have a net income below 10%. So these are interesting results we were able to achieve in the company with these BRL 64 million. So when we get into cash flow, we ended the quarter with BRL 242 million of cash, going from BRL 319 million. And here we can understand the working capital, where if we look at the company's history, the first quarter is more challenging. We perform some adjustments with the operators in the fourth quarter, and we also have pressure in the receipts in the first quarter of each year. So this year was a little higher than what we would like to be operating with. So there's two reasons for this. Once again, it's not what we think is interesting for the company, but it does help you guys to understand it's a lot more of a one-off occurrence than something that's actually recurring, such as the negative working capital. As the end of the quarter was right on Easter, we had three days in the end of March that did not have financial transactions. Some of our payments for consolidation, which are not from the controller, we had payments come in on the 1st of April, and this made us have BRL 20 million more in working capital in the quarter. Besides this, we had an all-time high revenue, which brings, considering the format of the health sector, will bring in a normal working capital, considering the company's growth. So we have about BRL 50 million, with these two joint effects that would, as I mentioned, bring us to numbers that are higher than what we would like, but closer to what we're operating with, in regards to 2023. So we see, quarter-o ver- quarter, the reduction of the working capital. And important points here on the cash flow graph, we had an investment of BRL 108 million, and it's important to highlight, and these are numbers that kind of deviate a bit. BRL 27 million are related to acquisitions. We're paying another installment of the Premium Hospital in Goiânia, and we had almost BRL 50 million invested in Nova Lima. As José Henrique mentioned, the opening is expected for the second semester. So at the end of this investment, we'll have approximately BRL 30 million or BRL 40 million to be invested still in this unit. So we have investments practically all complete. We have some payments such as since the construction process is in a real intense speed, we had some modifications. But we, especially if we consider some equipment, we've already made orders for. So we already have pretty anticipated numbers. So this is the maintenance CapEx is in line with what we mentioned. It's a very low percentage of the net revenue, but these are the very one-off numbers here. Now, on the bottom part of slide 10, you'll see the PME and PMP numbers. And we reached 120 days of average terms, and an increase of four days. Two days are due to the BRL 20 million that were paid on the 1st of April. There is no issue with a delay, that's unexpected. It's just a bank procedure because of the holiday. But this reflects on our accounting because we can't account for a payment that takes place in the morning of the 1st. So half of the values, to take are due to this. And as I mentioned, this happened in the consolidation of the company. So we expect that we'll have some units that are a little worse than the others. So if we analyze the same numbers, from the controller, they're stable and they're already on a downward trend. But we can see the chain of receipts, in our hands and a variation that we report with our consolidated numbers. That gives you access to the numbers from Contagem, which demonstrates that the major cash generation in the company coming from these units has control and stability and even a bit of an improvement. We had an increase in our stock levels, and also the average payment terms. Here we have a strategy in the company, which is normally in the month of March, which is something that we also have been implementing for many years. We anticipate some purchases due to the adjustments that occur in the month of April. So we increase a bit of the stock in March and also the average terms, buying a little more. We consume this throughout the second quarter, normally, with about 60 days. This happened mostly at the Contagem level, where you have a cash generation that's a little better. We implement this strategy as they generate the ROI. I'm moving on to slide 11. When we get into debt, it's very stable, 1.9. We have a slight increase compared to the fourth quarter, stable compared to the first quarter. Here you come into the investment aspect in Nova Lima. If we're a cash generator, if we didn't have this level of investments for a new unit, we would have a reduction in this indicator. It's important to mention that, as you all know, first you have the CapEx and you open up the unit and then you gain the results, obviously. Since it's a net debt to EBITDA ratio, during the construction period, you have this very occasional increase. But after the construction work is done, we have an expected drop in this indicator during 2024. The schedule or timeline was not changed. It's just a matter of adjusting 3 months on average, and an average amortization period of 4.6 years, 61% between the fourth and fifth years, which is where you have the maturity of our debentures that were first issued in by BRL 700 million. So you have a pretty big concentration in this period. And then, that's the longer tail part, with the debt level from the debt from BNB that will end in 2032. So the cost of debt is below CDI levels, due to this debt with the BNB where we had a swap and that transformed that. So we had this CDI minus 4.5 on average, and that makes the overall debt in the company operate below CDI, which helps us in our financial results in the company. So 95% of the company's debt is connected to CDI and about 5%, still of a remaining part from the BNDES debt. So I'm reaching the end here of our presentation, and I will get into Q&A so that we can go deeper onto any topics you would like to cover. Thank you so much for your presence. The first question is from Vinicius Figueiredo from Itaú BBA. Okay, Vinícius, you can speak. Let's open up your mic. Hi there. Now I can speak. But anyways, guys, good morning. I think I have a few points here, and Rafael has already started to answer them. But if we could just explore them a little bit more, with the scenario for non-payments, you mentioned that this is a scenario that's still uncertain in the next quarters because you still have a delicate situation with some payers and health insurance funds that pressure this. But if we look at this from a more bottom-up perspective, what do you think you can talk about, in regards to what was done as improvements in the processes and even mechanisms to discuss any non-payments or demand payments? And what can the company do internally to try to reduce this level? And if we would be able to have some kind of an improvement in the next quarters because of this, then a second point would be the movement to eliminate some credited partners. In the end of last year, we had a few of these events, and this year we have some hospitals that are stopping certain insurance plan services for more complex procedures. And how have you guys noticed this? Have you seen any kind of payer that you were more impacted by that decided to cancel their relationship with you guys, or did you benefit from some other payers that stopped using other hospitals and started using your hospital? Can you just explain a bit of this dynamic with the situation? Well, Vinicius, good morning. Thank you for your question. I'm going to just start talking about your second point, and then we'll go back, and I'll pass the floor on to Rafael to contribute and give us more details. In regards to the cancellations of certain partnerships, we've seen this trend in the sector with some changes, actually, and guidance from ANS providing more flexibility to certain payers to be able to perform some transactions and changes in their contracts. We saw this take place more frequently in our sector. We did not have an impact in our units that would be negative, but we did have a positive impact in certain units. When we look at a cancellation or a selection of certain specific procedures that are not going to be covered anymore by a certain insurance plan, of course, the demand from these beneficiaries still exists, right? The payers need to have some form of access for these patients with a medical team that's prepared and qualified to absorb this volume of services. And in certain units, we experienced this with even greater strength, right, where we had patients being sent to us coming from some other chain that had some kind of cancellation in the sense, and our units were benefited by this. We've been operating with partnering payers, and we haven't seen this in a negative way. So, we haven't seen this as a trend. We've been coming closer to the payers, and we've been understanding the moment that the payers are going through, and we think this has actually reached a relevant improvement process. We've seen this as something optimistic, and it's actually a year where we're trying to fix things up a bit, but with a more positive bias in regards to the last months we went through. And we consider this is not a relevant risk for our operations in the next months or quarters. So, in regards to the non-payment rates, we saw this trend with the increase of our non-payment rates in the last few months, and the operators needed to control their claims rates and better. So they delivered these instruments that helped increase the capacity for these payers to verify this with greater depth. And this did impact our operations, and we saw we needed to have some internal movements with the connection between our productive areas and our supply chain areas so that we could have better adjusted processes, incorporating more technology, and even bring additional support with this process. But to be able to talk about what we've done, I'll pass the phone to Rafael so he can give you a little more details. Well, Vinicius, this is a process because the supply chain, the payment receiving chain goes through many different areas in the company. If you've operated a hospital for more than 40 years, like we have, any kind of change really requires big efforts, and we know that very well. So sometimes with internal strength, things may take a little longer to be able to transmit this urgency. And we hired, folks, an external consulting firm. They've helped us map out the best practices that other hospitals and payers have, and also how they operate with insurance companies and payers. Our focus was really geared towards avoiding accounts that were stopped or unused and really reflect on how we could consider the correct revenue levels to generate cash. So this is not because the company was never focused on cash, but that's because the relationship with the payers always involved many sides kind of giving in in this process. Many people knew that operationally you would be able to perform these adjustments. But today we've been very selective when it comes to elective surgeries before getting the authorization, operational care with approval codes between what is requested and demanded. And sometimes codes that are cheaper for the payer, but they use that to be able to question why codes were not matching just because they're in a moment of difficulty. So sometimes it's not related to the quality of our services, but related to bureaucracy and how things are done about the payers' more higher scrutiny level. So we also had data in the systems that were not available. So what you may be shocked but some payment slips that the payers did not send us that made it difficult for us to consider the payments received. All of this is a process that we're completing with folks, and it's a project in the first semester. We've already had some initiatives that already been put into practice that we needed to change. And we've been working on a cleaner chain. So our focus here is really focused on governance, and we need to have the right people in the right positions because we had so that we can make decisions and not have our account just waiting on a better decision, but really understanding how we can make that become cash quickly and always based on technology and innovation. And these are all elements that we're very confident about. And internally, we are taking on an important quality leap, and the company was already doing this well done, but we suffered a bit. So the payers are going to move on to their third adjustment. It's double digits, and very important for the sector that has been absorbed by the payers and by who's hiring those plans. And we can also have some relief, which facilitates this kind of conversation, with greater strategies, avoiding de-accreditations and adjustments. And we're a lot closer to them with this understanding that things will be better. But of course, this is not 100% of the sample. You have some challenges, of course, that get in the way because these are very occasional things that sometimes take place that we need to handle with some strategic decisions. But when we notice an improvement in processes, we can also understand a better relationship and learning process with the payers. Okay, perfect. Very clear. Thank you, Rafael. Thank you, Henrique. So now we're going to move on to the next question by Yan Cesquim. Hi, good morning, José, Rafael, and everyone. I just have two questions here. The first one is about the occupancy rates. I understand that the significant increase of the occupancy comes from the strategy to have greater profitability in the operations, considering the nursing bill. But I want to know if you could give us a breakdown of the assets where you notice this kind of increase. If you could just show us a bit of where you guys notice this increase in occupancy rates, so we can notice this CapEx increase, and this is related to the Nova Lima Mater Dei. But I wanted to ask if you could all help share the expected budget for the CapEx in 2024. Thank you, guys. Well, Yan, I'm going to start off here about the occupancy rates. We've been bringing recurring information about this issue with the increase of the occupation rates, which is an important and relevant guidance for the company and the budget this year. So when we analyzed the chances of bringing in more efficiency in regards to the risks from the nursing bill and some changes that were taking place in the sector, we considered the assumption of the increase in the occupation rates in our units, and we performed the necessary measures and actions to make sure all of the units understood their challenges. And so when we look at this process, different units in the Mater Dei network have been working with higher rates of occupation considering the increase in the number of patients. We've been growing in a recurring manner with our levels of patients per day. So we've been mentioning the amount of surgeries, hospitalizations, and services in outpatient centers and emergency rooms, which have been very intense in all of our units. So the Metropolitan Region has had a significant increase of level in the services, growth of surgeries that's very significant considering this differentiated positioning. And more and more, our units have been standing out in this competitive environment as the main units in our region. And Nova Lima comes in as a complementary hospital, especially the Santo Agostinho and Contorno. And through this, we've been able to attract teams that are references and benchmarks, and they already start relating to us in this Metropolitan Region. So it's a fact that we had an increase of patients due to dengue. As Rafael mentioned previously, this pressures our average ticket. These are patients that are a little less complex. But we also noticed, on the same side, that there was significant growth in these elective procedures that helped us have this higher rate, helping with the new beds open to bring in more efficiency. This has happened here. It's happened in the central region of Brazil and also in our hub in Salvador and also in the north of the country. In regards to the CapEx, we also mentioned the greater exposure of our CapEx this year. Rafael mentioned Nova Lima. They were able to capture the biggest amount of investments. Last year, with this strategic composition of the Belo Horizonte Hub, we decided to increase the pace of investments in Nova Lima to be able to have this opening because we had already been receiving from some payers information about the need to grow in the amount of lives in that region. When we look at the Nova Lima region, we start noticing that if we didn't have this kind of quality equipment, we would have less incentives from the higher income people living around there to have plans that can really meet the needs of our location. So when you consider this unit there and this impressive equipment, we start noticing that we have an even greater amount of lives growing and to bring in a bit more of the details on the CapEx, etc. So I'm going to pass this on to Rafael. Well, Yan, just to mention and help you guys with the modeling, we haven't ran away from that number in regards to the net revenue of 1.5% when it comes to investments and maintenance. So what we can see as the outliers here is the acquisition of the BRL 27 million and Nova Lima as well, where during the year we have another BRL 30 million or BRL 40 million. So, when you eliminate these outliers, you can have some unexpected expectations. It's closer to the numbers here. And, of course, if you have something extraordinary, with a purchase, in line with the last quarter, you have a very occasional situation where we bought some land for a possible expansion, but it's like BRL 3 million, BRL 4 million, BRL 5 million only. So if that's, when you look at the forecast, and calibrate this model, you can consider this as which is what we're presenting here in the company. Okay, thank you. Our next question is from Ricardo Boiati. That's Safra. Hi, good morning, José Henrique and Rafael. Some questions here on my side. If you could maybe talk about Salvador and the ramp-up of the unit there and what are the specialties that are still below potential when it comes to the coverage, and also the contributions with the medical centers for the ramp-up in the Salvador unit. So any additional details you could share would help us a lot here. And if you can also talk about the MatMed line here, and the release, you mentioned the complexity is a little lower and that impacted the medical material line where you had a dilution that was really levered by the complexity in the quarter, which was a little bit smaller than what would be considered typical. But could you quantify this a little better and help us understand the contribution of complexity and if there's any additional efficiency gains in medical materials and better negotiations with suppliers and other initiatives that have been contributing to the evolution of this line? That would be great. Thank you so much, guys. Okay, thank you, Ricardo, for your question. A pleasure to speak with you. And as we talk about the ramp-up in Salvador, it's really a project that has been, making us very happy because of the way the hospital has been cared for and welcomed by the community in Salvador. The patients that have been contacting the hospital and search for our services, but also the medical community, it's quite impressive how physicians have been contacting us. These are like reference physicians to be able to incorporate in the hospital, bringing in their surgical procedures into the unit, incorporating the clinical with this point, which is our medical center. So, in this transition from November last year, one of the main points that we have been considering a lot is our important presence of Dr. Henrique in the meetings, as he's such an important reference in the health sector and also for these physicians. And next week, for example, we're going to be in Salvador with a full meeting with many very relevant physicians that have been demonstrating an interest in being closer to us and partnering. So when it comes to specialties, we've also grown a lot, and especially with the specialties that have like a higher footprint in our outpatient center and our emergency rooms. In Salvador, the emergency room is really growing a lot when it comes to experience, patient experiences in the last few months. And so this has been very positive. And we've seen relevant growth in general surgeries and also of medical clinic, clinical patients and orthopedics, relevant growth in gynecology and pediatrics, when we consider low, medium, and high complexity are already a reference for the hospital, for the region. And our ICUs, our neonatal ICUs and pediatric ICUs are quite full. Because of these surgical patients, the surgical emergency rooms have also been higher complexity levels. And we've been able to attract new specialties into the institution. So we've been able to bring new teams that bring in a very relevant volume of services for us. We understand the opportunities in certain specialties, but we are very much convinced that we'll be able to grow in some of these for the next few months so that we can also unleash the value we will be able to achieve in that unit because of the structure we built, which is one of the best structures in the country. It's very difficult to see something that at that level of quality. If you visit Salvador, for example, you can compare that unit with any other benchmark unit in the country, and you'll be very impressed with what's built there. When it comes to medical materials, this is a line we monitor very closely. Rafael has already talked about some of the movements we have every year, for investments before the readjustments to be able to improve, and take advantage of this possibility to allocate capital, improving our returns. So we worked on this this year, and this really helps when we look at the next months. We'll consider the relative profitability, but we've been also working on many different projects internally. We also have a very robust project internally with a big possibility to unleash value this year. This is a project that we brought, had to bring some external help to help conduct in our supply area, was able to manage this and conduct this to be able to take advantage of even more synergies besides the ones we were able to capture. Okay. Thank you. Thank you, Henrique. Okay. Next question is from Stella from J.P. Morgan. Hi everybody. Good morning. Thank you for taking my question. I would like to see if you could give us an update on how it's going with the partnership with Bradesco in the São Paulo hospital. And also, if you could comment a bit on the strategic plans of the company. What do you have been studying and what do you see as potential partnerships in this model, whether it be expansion in the areas that you already go or in other markets or in new markets as well? Thank you. Stella, thank you very much for your question. I think this gives us an opportunity to talk a little bit about a few relevant points. The project with Bradesco, the Santana project, is going forward at full steam ahead. We have defined in a strategic way the relationship that we have with Atlântica and BSP. We've also accelerated the chronogram of the definition of what the hospital will be, the characteristics of the hospital. We're in the final phase of the definition of that. So the number of beds the hospital will have, the number of surgical centers, etc. And what will be the logic of this hospital, the type of services that we'll offer. And with that, we've been able to evolve quite a bit. We've had several meetings about it in this sense. And we believe that shortly, this project will be up for approval. And once it's approved, we have and having conditions, we will be able to start the work on that, the construction on that, and make one of the most relevant hospitals in that region. We've done research also in the region to understand the behavior of the clinical body, the doctors, and the patients. This project will reflect greatly the needs that we have found through this behavior and what the population there needs. Because the population of patients there in that and what the medical population also needs. There are 2 million lives in the region, 2 million inhabitants in the northern São Paulo region. When we look at the addressable market in terms of lives, we have more than 600,000 people with health plans who could be attended by our hospital. It's much bigger than several large cities that we have in the country. Every day that passes, it's a project that brings us more and makes us happier and happier and gives us greater and greater expectations for the medium to long-term plans of the company. Your second point, in terms of strategic movements and partnerships, we always have our eyes open to that. The healthcare market and the hospital market has moved quite a bit. It's a market that is in evolution. A lot of things are in movement. We have the full conviction that at these moments, opportunities, relevant opportunities appear for us to position ourselves. Our appetite for growth, to extract value and from these values continues and has even grown quite a bit. Once we see that we're able to perform better and better and also our assets in relation to the assets of the competition, we have been able to observe, Stella, with a great, really looking then looking inside with an inclusive vision of what we can what we can prepare internally to be able to take the next steps in other types of partnerships or other types of opportunities. As I said in my initial talk, this this movement of allocation of capital, of opportunities to understanding in-house what we need to prepare to be able to make these other movements, what type of movement we have to do. In fact, in a vision, a strategic vision of our portfolio, we have looked quite a bit at that and to prepare the company for the next strategic for our next strategic movements. At these moments, when there's a point of reflection about the sector and the sectors with where we operate, it brings moments of difficulty and important reflections. We have had a lot of internal discussions with our directors, with our board, particularly with the board to be able to understand that wave of M&As that we had, people running crazily after assets. We have stopped to sit and reflect, look at our portfolio and our strategy. We've reflected quite a bit about that from this next steps that we should be taking, always looking at a healthy company that will not put it in risk. We saw a few examples of people who were strangled by the financial results with very, very high interest rates. So we're always calibrating our debt, our strategy, hubs, positioning. It's something that passes heavily through our discussions and the time and energy that we spend inside. The next question. I just wanted to say thank you. That's very clear. Thank you. Thank you, Stella. Looking into the question of Marcio from Bradesco. Good morning, Henrique and Rafael. Two questions. The first is in relation to this effect that you've seen, the effect of dengue and respiratory diseases. Can you tell us what region has had this effect, the most relevant effect from this? And if how much of this growth that has been in the number of internments and the number of patients has a this number of have been connected with these respiratory diseases? And the second question is, if you could comment a bit on the operation of the Porto Dias, we saw a falloff of 30% in the number there. Then we'd thank you for any comments you have on that. Hi, Marcio. In relation to dengue, we had an increase. It brought the highest impact in the metropolitan area of Belo Horizonte. It was a region, the region that was most affected, more affected than other regions. We saw that at the beginning of the dengue period, the most affected region was the metropolitan area of BH. Also we had the effect in the central area in Brazil as well, which seemed to be a city that suffered greatly. Goiânia also was a city that had a good dose of dengue at that period. With these two principal regions where we saw the highest impact, in the other regions, we had some growth, but nothing exaggerated in relation to what we see in normal periods. In relation to respiratory diseases, this is a period of increased respiratory diseases. We have units. In our units, the majority of them have pediatrics in a relevant way. The number of hospitalizations for pediatric hospitalizations suffer more at these moments. However, it is seasonality and it's expected. We're not having in our units any growth much bigger than what we've had in past years. Dengue, yes, we did have a higher impact than normal. But the respiratory diseases overall, even though this in spite of the seasonality, we see much different we don't see much different than other periods. In relation to these movements, minority movements that you mentioned, it's a point that it happened in this period. We've had an indication of a change in management, which is already foreseen internally for one of our hospitals. This made the movement on the part of some investors that we have specifically and the patients that are being treated, the options are on the table for us to discuss. We follow along with these internal discussions so that this causes the smallest possible impact for Mater Dei. On the other hand, so that we can also take advantage of these discussions to come out strengthened and improve our positioning after that. Okay, Marcio, any more questions? No, just if you had this number, an idea of this growth of patients per day of 13% year-on-year. It was 3% in the fourth quarter. If you haven't had, why do you to what do you attribute this delta due to dengue? Just one more point in relation to dengue, one clarification. The great majority of the dengue services do not generate hospitalization. These are patients who consume a great deal in terms of emergency room care. They consume a great deal of outpatient clinics. These are patients who do many laboratory tests. But only a small part of these patients wind up being hospitalized. On the other hand, what we did have a lot in this period were the growth of patients, elective patients. So in our analyses that were done, we did not attribute this growth, this relevant growth in terms of revenue to this specific point of dengue. This definitively is not what moved our speedometer in terms of the profitability of the company. We talked about lower average tickets because we have more attendance, more services rendered. And but that's not what changed so much, this growth of 13%. Thank you, Henrique. Thank you very much. So there's just that one question in the chat about the question of the it's not full. Our hospital beds are not full. We have strategies within this question. We understand that the contracts that need to be signed, where we have the readjustments and the negotiation with the unions, in our case, we anticipated this. And we already published this in our part of our strategy. It's parceled during 2024, one part of 2024 and 2025, the majority in 2024. And the other question that was made, it's also important to accompany the developments in other states and other networks to know if this is a question of the regionalization, which was something that we conquered in our discussions, in our judicial discussions. And if this is better, reflects better rather than what we saw with the nurses. So it's very important. In our case, strategically, we have taken a position in relation to what we did with our other employees. The impact is still what we felt over the year. We hope to assert this with internal changes and other conversations with the payers so that we can look at the real numbers of the company. Thank you for answering the questions. If there's no more questions, we want to thank you all for your interest and for the questions today. Thank you for having listened to us. As we said earlier, this first quarter, in our vision, demonstrates very positively the way in which the company has behaved in this beginning of 2024. We are fully convicted that in the next few months, we will be able to demonstrate results even more exciting. We're very optimistic with the ramp-up of some of our units and attending that the company is on the heading in the right road. Thank you for your interest, and especially for those who have invested and believed in our belief, in our work. Thank you all. Good day to all.