Article Text

Download PDFPDF
Association of women leaders in the C-suite with hospital performance
  1. Adrienne N Christopher1,2,
  2. Ingrid M Nembhard3,
  3. Liza Wu2,3,
  4. Stephanie Yee3,4,
  5. Albertina Sebastian5,
  6. Nidhi Charan6,
  7. Simone Betchen3,5
  1. 1Department of General Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
  2. 2Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  5. 5Division of Neurosurgery, Department of Surgery, Maimonides Medical Center, Brooklyn, New York, USA
  6. 6Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  1. Correspondence to Dr Simone Betchen, Maimonides Medical Center, Brooklyn, NY 11219, USA; sbetchen{at}hotmail.com

Abstract

Background Women comprise 50% of the healthcare workforce, but only about 25% of senior leadership positions in the USA. No studies to our knowledge have investigated the performance of hospitals led by women versus those led by men to evaluate the potential explanation that the inequity reflects appropriate selection due to skill or performance differences.

Methods We conducted a descriptive analysis of the gender composition of hospital senior leadership (C-suite) teams and cross-sectional, regression-based analyses of the relationship between gender composition, hospital characteristics (eg, location, size, ownership), and financial, clinical, safety, patient experience and innovation performance metrics using 2018 data for US adult medical/surgical hospitals with >200 beds. C-suite positions examined included chief executive officer (CEO), chief financial officer (CFO) and chief operating officer (COO). Gender was obtained from hospital web pages and LinkedIn. Hospital characteristics and performance were obtained from American Hospital Directory, American Hospital Association Annual Hospital Survey, Healthcare Cost Report Information System and Hospital Consumer Assessment of Healthcare Providers and Systems surveys.

Results Of the 526 hospitals studied, 22% had a woman CEO, 26% a woman CFO and 36% a woman COO. While 55% had at least one woman in the C-suite, only 15.6% had more than one. Of the 1362 individuals who held one of the three C-suite positions, 378 were women (27%). Hospital performance on 27 of 28 measures (p>0.05) was similar between women and men-led hospitals. Hospitals with a woman CEO performed significantly better than men-led hospitals on one financial metric, days in accounts receivable (p=0.04).

Conclusion Hospitals with women in the C-suite have comparable performance to those without, yet inequity in the gender distribution of leaders remains. Barriers to women’s advancement should be recognised and efforts made to rectify this inequity, rather than underusing an equally skilled pool of potential women leaders.

  • career development
  • clinical leadership
  • leadership assessment
  • medical leadership
  • senior medical leader

Data availability statement

Data are available upon reasonable request. Statistical models are available upon reasonable request.

Statistics from Altmetric.com

Data availability statement

Data are available upon reasonable request. Statistical models are available upon reasonable request.

View Full Text

Footnotes

  • Contributors ANC, LW, SY, SB: project planning, data collection and management, data analysis, drafting of the manuscript, critical revisions of the manuscript. IN: data analysis, drafting of the manuscript, critical revisions of the manuscript. AS, NC: data collection and management, drafting of the manuscript, critical revisions of the manuscript. SB guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.