Table 1. A summary of studies included... | Emerald Publishing

Table 1.

A summary of studies included in the review

No.	Author/source/year	Country	Objective	Study design	Outcome	Study limitation
1	Amanda H. Goodall Social Science and Medicine, 2011 Goodall (2011)	US	To compare the ranked quality between hospitals led by CEOs who are physicians and those who are non-physician managers	Method: Cross-sectional Location: Top 100 US hospitals in 2009	The majority of CEOs, i.e. 16 out of 21, were physicians A strong positive association between the ranked quality of a hospital and whether the CEO was a physician or not. However, longitudinal inquiries are recommended to establish that physician-leaders improve the performance of hospitals compared to professional managers. Other important variables, such as a CEO’s tenure and the level and number of years of clinical experience that each CEO had obtained are important factors	Cross-sectional analyses cannot be used to infer causality because a temporal sequence cannot be established
2	Gianluca Veronesi et al. Social Science and Medicine Journal, 2013 (Veronesi et al., 2013)	UK	To determine the impact of clinician appointment to the boards of directors of the NHS hospital trusts	Method: Cross-sectional Location: NHS hospitals in England	The analysis reveals a significant and positive association between a higher percentage of clinicians on boards and the quality ratings received by the service providers. This positive influence is also manifested in lower morbidity rates. Analysis results excluded the possibility of reverse causality (doctors joining boards of already successful organizations)	Not stated
3	Michael C. Tasi et al. Health Care Management Review, 2017 Tasi et al. (2017)	US	To examine whether hospital systems led by physicians were associated with better US news and world report (USNWR) quality ratings, financial performance and operating efficiency as Compared with those led by non-physician managers	Method: Cross-sectional Location: US hospitals	Large hospital systems led by physicians received higher USNWR ratings and bed usage rates than did hospitals led by non-physicians. However, there was no difference in financial performance The results imply that physician leaders may possess skills, qualities, or management approaches that positively affect hospital quality and the value of care delivered	Other confounders may affect the correlation between leadership and hospital quality but certain characteristics were hard to obtain for the analysis. Leaders were only categorized based on their medical degree and other potentially relevant characteristics such as prior health-care administration education and experience, other advanced degrees, or tenure in the health-care industry were not assessed
4	Collins Yazenga and Mkandawire Dissertation PhD Walden University, 2017 Mkandawire (2017)	US	To examine Whether physician or non-physician CEOs perform better in US hospitals based on hospital net income, patient experience ratings and mortality rates	Method: Cross-sectional study Location: 60 US hospitals	No significant differences between hospitals’ net income, patient experience ratings, or mortality rates in hospitals led by non-physician and physician CEOs. Thus, physician and non-physician CEOs may produce similar outcomes and hospital boards can view CEO applicants equally	This process of data compilation could affect the data integrity due to the potential inaccuracies in the reporting of hospital-related mistakes. Convenience sampling methodology was used so the variables in the study were predefined by environmental course
5	Florian Kaiser et al. Social Science and Medicine, 2020 Kaiser et al. (2020)	Germany	To examine the link between the educational background of a hospital's CEO and hospital performance in terms of medical quality and financial success	Method: Cross-sectional Location: 370 German hospitals	Physician-led hospitals have significantly lower in-hospital mortality rates for pneumonia and higher patient satisfaction In contrast, institutions led by managers with economics or business degrees showed better financial performance and superior outcomes for hip and knee surgeries The findings support prior results regarding financial outcomes and mortality	The broad spectrum of measures for clinical quality in the study meant that a straightforward interpretation that physician CEOs lead to superior medical quality could not be conclusively established A considerable number of hospitals were excluded due to missing data
6	Youssef Fares et al. Surgical Neurology International, 2018 Fares et al. (2018)	Arab world	To explore whether hospitals led by physician leaders perform better than hospitals led by non-physician managers	Method: Cross-sectional Location: Hospitals in Arab World	Physician leadership was significantly associated with lower hospital ranking (bottom 50 hospitals) in the Arab World	Only one hospital quality indicator was used for ranking. For better evaluation, the ranking system must also focus on patient satisfaction and perception of quality to evaluate the impact of medical leadership
7	Ge bai and Ranjani Krishnan American Journal of Medical, 2015 Bai and Krishnan (2015)	US	To examine whether hospitals without physician participation on their boards of directors deliver lower Quality of care	Method: Cross-sectional Location: California non-profit hospitals	The lack of physician representation on hospital boards is associated with lower quality of care In other words, physicians as directors add important value to hospital quality of care	Only confined to one state, California The data obtained from the hospital quality alliance (HQA) program included only major medical conditions that might not accurately reflect the overall hospital quality of care Self-reported quality of care data by hospitals can have data manipulation
8	Gianluca Veronesi et al. Public Administration, 2015 Veronesi et al. (2015)	UK	Does increased participation of clinical professionals on hospital boards impact positively performance outcomes (patient experience)?	Method: Cross-sectional Location: Acute hospital sector in the NHS	Clinical participation on hospital governing boards significantly improved the patient experience of the care provided	Not stated

No.	Author/source/year	Country	Objective	Study design	Outcome	Study limitation
1	Amanda H. GoodallSocial Science and Medicine, 2011Goodall (2011)	US	To compare the ranked quality between hospitals led by CEOs who are physicians and those who are non-physician managers	Method:Cross-sectionalLocation:Top 100 US hospitals in 2009	The majority of CEOs, i.e. 16 out of 21, were physiciansA strong positive association between the ranked quality of a hospital and whether the CEO was a physician or not. However, longitudinal inquiries are recommended to establish that physician-leaders improve the performance of hospitals compared to professional managers. Other important variables, such as a CEO’s tenure and the level and number of years of clinical experience that each CEO had obtained are important factors	Cross-sectional analyses cannot be used to infer causality because a temporal sequence cannot be established
2	Gianluca Veronesi et al.Social Science and Medicine Journal, 2013(Veronesi et al., 2013)	UK	To determine the impact of clinician appointment to the boards of directors of the NHS hospital trusts	Method:Cross-sectionalLocation:NHS hospitals in England	The analysis reveals a significant and positive association between a higher percentage of clinicians on boards and the quality ratings received by the service providers. This positive influence is also manifested in lower morbidity rates. Analysis results excluded the possibility of reverse causality (doctors joining boards of already successful organizations)	Not stated
3	Michael C. Tasi et al.Health Care Management Review, 2017Tasi et al. (2017)	US	To examine whether hospital systems led by physicians were associated with better US news and world report (USNWR) quality ratings, financial performance and operating efficiency asCompared with those led by non-physician managers	Method:Cross-sectionalLocation:US hospitals	Large hospital systems led by physicians received higher USNWR ratings and bed usage rates than did hospitals led by non-physicians. However, there was no difference in financial performanceThe results imply that physician leaders may possess skills, qualities, or management approaches that positively affect hospital quality and the value of care delivered	Other confounders may affect the correlation between leadership and hospital quality but certain characteristics were hard to obtain for the analysis. Leaders were only categorized based on their medical degree and other potentially relevant characteristics such as prior health-care administration education and experience, other advanced degrees, or tenure in the health-care industry were not assessed
4	Collins Yazenga and MkandawireDissertation PhD Walden University, 2017Mkandawire (2017)	US	To examineWhether physician or non-physician CEOs perform better in US hospitals based on hospital net income, patient experience ratings and mortality rates	Method:Cross-sectional studyLocation:60 US hospitals	No significant differences between hospitals’ net income, patient experience ratings, or mortality rates in hospitals led by non-physician and physician CEOs. Thus, physician and non-physician CEOs may produce similar outcomes and hospital boards can view CEO applicants equally	This process of data compilation could affect the data integrity due to the potential inaccuracies in the reporting of hospital-related mistakes.Convenience sampling methodology was used so the variables in the study were predefined by environmental course
5	Florian Kaiser et al.Social Science and Medicine, 2020Kaiser et al. (2020)	Germany	To examine the link between the educational background of a hospital's CEO and hospital performance in terms of medical quality and financial success	Method:Cross-sectionalLocation:370 German hospitals	Physician-led hospitals have significantly lower in-hospital mortality rates for pneumonia and higher patient satisfactionIn contrast, institutions led by managers with economics or business degrees showed better financial performance and superior outcomes for hip and knee surgeriesThe findings support prior results regarding financial outcomes and mortality	The broad spectrum of measures for clinical quality in the study meant that a straightforward interpretation that physician CEOs lead to superior medical quality could not be conclusively establishedA considerable number of hospitals were excluded due to missing data
6	Youssef Fares et al.Surgical Neurology International, 2018Fares et al. (2018)	Arab world	To explore whether hospitals led by physician leaders perform better than hospitals led by non-physician managers	Method:Cross-sectionalLocation:Hospitals in Arab World	Physician leadership was significantly associated with lower hospital ranking (bottom 50 hospitals) in the Arab World	Only one hospital quality indicator was used for ranking. For better evaluation, the ranking system must also focus on patient satisfaction and perception of quality to evaluate the impact of medical leadership
7	Ge bai and Ranjani KrishnanAmerican Journal of Medical, 2015Bai and Krishnan (2015)	US	To examine whether hospitals without physician participation on their boards of directors deliver lowerQuality of care	Method:Cross-sectionalLocation:California non-profit hospitals	The lack of physician representation on hospital boards is associated with lower quality of careIn other words, physicians as directors add important value to hospital quality of care	Only confined to one state, CaliforniaThe data obtained from the hospital quality alliance (HQA) program included only major medical conditions that might not accurately reflect the overall hospital quality of careSelf-reported quality of care data by hospitals can have data manipulation
8	Gianluca Veronesi et al.Public Administration, 2015Veronesi et al. (2015)	UK	Does increased participation of clinical professionals on hospital boards impact positively performance outcomes (patient experience)?	Method:Cross-sectionalLocation:Acute hospital sector in the NHS	Clinical participation on hospital governing boards significantly improved the patient experience of the care provided	Not stated

Source: Authors’ own work