Clinicians in Governance: Evidence for Hospital Performance from the Italian NHS

Wednesday, July 16, 2014: 6:18 PM
Room: 414
Oral Presentation
Fabrizia SARTO , Federico II University of Naples, Napoli, Italy
Gianluca VERONESI , Leeds University Business School, University of Leeds, Leeds, United Kingdom
Ian KIRKPATRICK , Leeds University Business School, University of Leeds, United Kingdom
Corrado CUCCURULLO , Second University of Naples, Italy
The study explores the effects of clinicians’ involvement in governance on hospital performance through an empirical investigation in the Italian NHS.

By drawing on the board human capital literature (Hillman & Dalziel, 2003; Kor & Sundaramurthy, 2008; Kroll et al., 2008) and the empirical evidences on clinicians in hospital governance (Dorgan et al., 2010; Goodall, 2011; Molinari et al., 1995; Veronesi et al., 2013), we develop our research hypotheses. More specifically we conjecture that hospital chief executive officer (CEO)’s (i) clinical expertise, (ii) previous governance experiences in the NHS, (iii) public health specialization, and (iv) business/administration specialization, have individually a good effect on the organizational performance.

We focus on public hospitals. Data are collected for 3 years and the sample is composed by 278 observations. CEO’s expertise, experience and specialization are main independent variables. Six indicators in terms of financial/non-financial performance are instead used to measure the hospital performance. We employ a panel data approach and we estimate different empirical fixed/random effect models.

Main findings report a positive (negative) effect of clinical CEOs on non-financial (financial) performance. By contrast, non-clinical CEOs negatively (positively) influence the non-financial (financial) dimension. Paper argues a differentiation in the provision of skills to the strategic process, as well as in the relationships with the clinical/non-clinical staffs. Findings also report good effects of CEO’s previous governance experiences and public health specialization.

Paper contributes to research in different ways. First, we corroborate the relevance of human capital in governance for the organizational performance. Second, we discuss the dissimilar effects of clinical/non-clinical expertise by arguing their reasons in setting peculiarities. Finally we investigate never explored effects of clinical/non-clinical specializations and experiential background.

For what concerns the practice, we suggest policy makers to pay more attention to the expertise legal requirements for CEO candidates.