Healthcare operations multinationals are far more likely to establish subsidiaries in North America than the average multinational company (MNC), according to analysis of GlobalData’s exclusively compiled subsidiary database.

Investment Monitor’s MNC subsidiary database contains information for 2,188 of the world’s top companies by revenue. Of these MNCs, 15 are in the healthcare operations industry, representing 0.7% of the companies in our database.

These healthcare operations companies are less likely than average to establish subsidiaries in western Europe (9.1% versus 36.8%) and are more likely to establish them in North America (78.7% versus 27.8%).

Overall, the 15 healthcare operations MNCs in our database operate 4,701 subsidiaries. This comes to an average of 313.4 subsidiaries per company, compared with an average of 99 for the entire database of 2,188 companies. It should be noted, however, that the number of subsidiaries is by no means evenly distributed within the sector. The most common number of subsidiaries for an MNC in the sector (the mode) is 107, while the median comes in at 109, indicating that the simple average is skewed heavily by the bigger parent companies.

US-based HCA Healthcare has the largest number of subsidiaries among the healthcare operations sector MNCs within our database with 2,452. This means it ranks in second place across our entire database when measured by the total number of subsidiaries.

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HCA Healthcare has more subsidiaries than any other multinational company in the industry. (Photo by Rusty Russell/Getty Images)

Where does HCA Healthcare place its subsidiaries?

HCA Healthcare’s subsidiaries are distributed across the world, but a huge 97.1% of the total are located in North America. Some 2,380 of HCA Healthcare’s subsidiaries are located in its home country of the US, while the UK is the second most popular destination with 59.

After HCA Healthcare, Universal Health Services has the second-largest number of subsidiaries within the healthcare industry with 576, while DaVita is third with 457 and Encompass Health is fourth with 219.

Overall, 4,221 of the subsidiaries owned by the healthcare operations MNCs in the database are located in the same country as the parent company was headquartered. This means that MNCs in the sector are more likely than average to have a preference for domestic subsidiaries at 89.8%, with the figure for the entire database standing at 45.7%.


GlobalData has compiled a list of top MNCs based on revenue. Any top companies that did not have a subsidiary were removed from the list. The latest company annual reports (2019 and 2020, where available) and websites were analysed for a total of 2,188 companies.

For a subsidiary to be included, the parent company had to have a majority ownership/control in the subsidiary. Affiliates, associates, joint operations and joint ventures were included as long as the ownership criteria was met. Subsidiary information was captured at a country level. Country names were standardised. In total, 216,898 subsidiaries were captured.

This article originally appeared in Hospital Management.