1. Instituto Nacional de Rehabilitación Maricela Verdejo Silva PhD

2. Background Administrative Director, one of the five main departments in the Instituto Nacional de Rehabilitación PhD in Administration Experience: 40 years in governmental ministries; 30 years teaching; 15 years in administration; 15 years in health services

3. Health, as a Constitutional Right Healthcare System Structure ◊Private ◊Public I.Primary attention (149 units) II.Non Specialized Hospitals (351) III.Specialized Hospital of Reference (79) IV.National Institutes of Health (13) Health, as a Constitutional Right Healthcare System Structure ◊Private ◊Public I.Primary health centers (12,253) II.Non-specialized Hospitals (351) III.Specialized Reference Hospitals (79) IV.National Institutes of Health (13)

4. 684 Beds destined exclusively to Orthopedics in Public Services

5. Instituto Nacional de Rehabilitación High Level Metrics Beds (157) Operating rooms (10) Examination rooms out-patient clinic (20) Intensive Care Unit beds (8) Emergency room beds (8) Imaging and Clinical Lab ◊X ray rooms (5) ◊X ray mobile units (7) ◊64 slice CT Scan (1) ◊Magnetic Resonance (1) ◊Ultrasonography (1) ◊BMD (1) ◊Clinical analysis Laboratories

6. Specialized human resources Orthopedic surgeons: 71 Other physicians: ◊Physiatrists: 58 ◊Anesthesiologists: 39 ◊Intensive Care Specialists:13 ◊Nurses: 457 ◊PT & OT: 142 ◊Paramedics:44

7. Unique Technology Motion Analysis, Robotic gait training, Acuatherapy, Imaging

8. ESEM, Transmission EM, Confocal Microscpy

9. Digital ORs & Surgical Biotechnology Unit

10. Surgical procedures

11. Financial performance 2010 90,7 MD ◊Government resources: 84,2 MD ◊Self generated resources: 5,6 MD ◊Governmental support for research: 5 MD

12. Teaching and Research Efforts Residents (136) Subspecialty Fellowship programs (12) Master´s degree courses (2) Scientific PhD course (1) Investigators (53) Publications 2009 (81)

13. Subspecialty Fellowship programs Hip and knee Replacement Shoulder and elbow Replacement Orthopedic Sports Surgery and Arthroscopy Spine surgery Hand surgery and microsurgery Pediatric Orthopedics Orthopedic Oncologic Neuromuscular deformities and foot and ankle surgery Orthopedic rehabilitation Occupational rehabilitation Pediatric rehabilitation Regional Anesthesia

14. Strategic Plan Development and Strengthening of: – Joint replacements – Chondrocyte and cell implantation – Regenerative Medicine – Hand Transplantation – Intervertebral disk Replacement – Osteosynthesis – Bioengineering – Increase number of orthopedic research protocols – Increase orthopedics specialty training

17. Gracias

19. Instituto Nacional de Rehabilitación Thanks for your attention