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Managers and Public Hospital Performance

Author

Listed:
  • Pablo Muñoz
  • Cristóbal Otero

Abstract

We study whether the quality of managers can affect public service provision in the context of public health. Using novel data from public hospitals in Chile, we show how the introduction of a competitive recruitment system and better pay for public hospital CEOs reduced hospital mortality by 8 percent. The effect is not explained by a change in patient composition. We find that the policy changed the pool of CEOs by displacing doctors with no management training in favor of CEOs who had studied management. Productivity improvements were driven by hospitals that recruited higher quality CEOs.

Suggested Citation

  • Pablo Muñoz & Cristóbal Otero, 2025. "Managers and Public Hospital Performance," American Economic Review, American Economic Association, vol. 115(11), pages 4040-4074, November.
    • Handle: RePEc:aea:aecrev:v:115:y:2025:i:11:p:4040-74
    DOI: 10.1257/aer.20240615
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    More about this item

    JEL classification:

    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • G34 - Financial Economics - - Corporate Finance and Governance - - - Mergers; Acquisitions; Restructuring; Corporate Governance
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J45 - Labor and Demographic Economics - - Particular Labor Markets - - - Public Sector Labor Markets
    • M54 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Personnel Economics - - - Labor Management
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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