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Career histories and managerial performance of health care chief executive officers: An empirical study in the Italian National Health Service

Mascia, Daniele; Piconi, Ilaria

doi: 10.1097/HMR.0b013e31823dc85b

Background: Organizational studies widely acknowledge the importance of the relationship between CEO’s career histories and managerial performance. Although the health care management literature largely explores the role of CEOs, whether and how top managers’ career histories affect their own performance remains still unknown in this industry.

Purpose: The aim of this study was to investigate the career histories of health care CEOs and to explore their impact on managerial performance.

Methodology: Primary data were collected from a sample of 124 CEOs leading health care organizations in the Italian National Health Service in 2008. Biographic data were accessed to gather information about relevant CEOs’ demographics and their career histories. The relevance of CEOs’ prior experience was considered, taking into account the prominence of health care organizations in which they passed through in their career histories. Regression analyses were employed to assess the impact of CEOs’ career histories on their managerial performance.

Findings: Top managers already appointed as CEOs were more likely to achieve higher levels of performance. Careers with long tenure within the National Health Service appear to increase managerial performance. Those CEOs who accumulated prior experience in a large number of health care structures and who spent time working at the most prominent hospitals were also more likely to achieve higher levels of managerial performance.

Implications: In health care, a CEO’s career history does impact his or her managerial performance. Specifically, patterns of career that imply higher mobility across health care organizations are important. Although interorganizational mobility is significant for CEO performance, the same does not hold for mobility across industries. These findings contribute to the current debate about the need for management renovation within health care organizations.

Daniele Mascia, PhD, is Assistant Professor of Health Care Management, Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy. E-mail:

Ilaria Piconi, is PhD candidate in Health Care Management, Department of Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. E-mail:

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

© 2013 Lippincott Williams & Wilkins, Inc.