Study: Senior Public Management System has reduced the hospital mortality rate by 8%

The Civil Service selection process substantially increased the proportion of directors with college degrees in management and medical directors with postgraduate degrees in management, indicated an analysis by UC Berkeley and MIPP.

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A study carried out by the University of California at Berkeley (UC Berkeley) and the Institute for Research on Market Imperfections and Public Policy (MIPP) concluded that the Senior Public Management System (ADP) reduced the hospital mortality rate by 8% in Chile.

The Managers and Public Hospital Performance analysis, which was carried out by UC Berkeley doctor and Columbia University professor, Cristóbal Otero, together with University of Chile academic and MIPP researcher, Pablo Muñoz, indicated that together with the decrease , there was also a substantial increase in the proportion of directors with university degrees in management and of medical directors with postgraduate degrees in the area of administration.

How was the study done?

The study used records of hospital discharges and deaths, as well as information on the identity, seniority, educational background, and demographic characteristics of the directors of all public hospitals between 2001 and 2019. In addition, it reviewed data on hospital supplies and procedures.

Using this information, the authors estimated the causal effect of the reform on the hospital mortality rate, comparing the performance of hospitals before and after an ADP-elected director took office, with respect to the performance of hospitals that have not adopted the reform. policy.

The investigation also documented that prior to the 2003 ADP reform, in practice all directors were doctors, and the vast majority had no management and administration studies. But after the reform there was a significant increase in the number of directors (physicians and non-physicians) with management studies.

“The reform had a positive impact on hospital performance”

“In this line, directors with management qualifications managed to better manage the resources granted by the State, making, for example, more efficient use of the operating room and reducing staff turnover,” said Muñoz.

Under this point, Otero maintained that the statistical study “shows that the Civil Service reform had a positive impact on hospital performance, and also suggests that training in management and administration of hospital directors is essential to improve and make more efficient the operation of public hospitals in Chile”.