All ETDs from UAB

Advisory Committee Chair

Nancy Borkowski

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


One of the most pressing issues in healthcare strategic leadership research is identifying which hospital chief executive officer (CEO) characteristics possess a significant and favorable relationship to organizational performance. However, little is known about the relationship between hospitals led by doctoral-educated CEOs and organizational performance. This study adds to our knowledge by examining the relationship between doctoral-educated hospital CEOs and selected financial and patient safety outcomes. UET served as the theoretical framework and guided the examination of the relationship between the selected dependent and independent variables. This study’s population included 509 acute-care hospitals across nine states, requiring a minimum four-year hospital CEO tenure, to examine the relationship between hospital CEO completed doctoral education (inclusive of professional and research-based) and organizational performance. The analysis method used in this quantitative, cross-sectional, nonexperimental study included bivariate regression, OLS multivariate linear regression, and ordinal logistic regression. The direction of the significant relationship with hospital operating margin, however, was counter to the association hypothesized in this study. On average, a hospital being led by a doctoral-educated CEO had a -0.40% lower hospital operating margin compared to a hospital being led by a CEO without a doctoral degree (p-value = 0.002). For hospitals earning a Leapfrog Hospital Safety Grade of A or B, there were 87% higher odds that those hospitals were led by a CEO with a doctoral degree, compared to those hospitals led by a CEO without a doctoral degree (p-value < .05). This finding supported the study’s hypothesis. Hospital CEO doctoral education did not result in a statistically significant relationship with CMS Overall Hospital Quality Star Ratings. Implications of this study may be advantageous for healthcare executive search firms and hospital governance stakeholders in evaluating recruitment, hiring, retention, and succession strategies involving hospital CEOs within the United States.



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