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American Economic Review Vol. 115 No. 11 2025

Managers and Public Hospital Performance

Pablo Muñoz1; Cristóbal Otero2

1 Departamento de Economía, Facultad de Economía y Negocios, Universidad de Chile and FGV EPGE (email: ) · 2 Columbia Business School (email: )

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.

DOI
10.1257/aer.20240615
Volume
115
Issue
11
Pages
4040-4074
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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