Does Management Matter in Healthcare?

We collect data on management practices for operations, targets and human resources in 2,000 hospitals in Brazil, Canada, France, Germany, India, Italy, Sweden, UK and the US. These management practices are strongly associated with better clinical outcomes, such as heart attack survival rates, and financial outcomes like profits. We show that hospitals with more clinically trained managers, that are larger, that operate in more competitive markets, and that are not government owned appear to have significantly higher management scores. The US and UK have the highest average management scores, which we think may be due to relatively politically independent appointment of hospital leaders and stronger accountability mechanisms.