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What happens to population health when the doctors leave? Evidence from the exit of Cuban doctors in Brazil

Author

Listed:
  • Sliwa Ruiz, Stefan
  • Becker, Malte
  • Hone, Thomas
  • Rocha, Rudi

Abstract

This paper studies the effects of a large-scale exit of doctors on population health outcomes, health production inputs, outputs, and health system adaptation in Brazil. Identification exploits the exogenous timing of the Cuban exit from municipalities that relied more versus less on Cuban doctors within the More Doctors Program. We find persistent reductions in the care of chronic diseases, while service utilization for conditions requiring immediate care, such as maternal-related services and infections, quickly recovered. Reductions in utilization did not translate into changes in health outcomes. Supply-side response and demand diversion helped mitigate major adverse repercussions for population health at the market level.

Suggested Citation

  • Sliwa Ruiz, Stefan & Becker, Malte & Hone, Thomas & Rocha, Rudi, 2026. "What happens to population health when the doctors leave? Evidence from the exit of Cuban doctors in Brazil," Journal of Health Economics, Elsevier, vol. 106(C).
    • Handle: RePEc:eee:jhecon:v:106:y:2026:i:c:s0167629625001341
    DOI: 10.1016/j.jhealeco.2025.103099
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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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