Is medical leadership associated with better hospital management? Evidence from a structural analysis of hospitals in Germany

Background/Aims Excellent hospital leadership is essential for the delivery of high-quality care and financial viability of healthcare services. In Germany, the role of chief executive officer of a hospital can be held by an individual with a medical or non-medical background. This study explored the potential differences between the structural and financial parameters of hospitals, depending on the background of their chairperson or chief executive. Methods Publicly available data on financial and structural parameters for 178 hospitals in Germany from the years 2015, 2016 and 2017 were collected and mean values were calculated for all variables. Nearest-neighbour matching was performed to allow comparisons to be made between hospitals with medical and non-medical leadership. Results While the results showed no significant differences between leadership types in terms of financial results, the values for structural characteristics, especially staffing levels, number of inpatient cases and case mix index values, were significantly higher for hospitals with medical leadership versus non-medical leadership. Conclusions Hospital leadership structure is a crucial factor in organisational performance. The presence of a person with a medical background at the top level of hospital management can have a beneficial impact on the delivery of healthcare.