What happens to population health when the doctors leave? Evidence from the exit of Cuban doctors in Brazil
File(s)
Accepted version
Author(s)
Sliwa Ruiz, Stefan
Becker, Malte
Hone, Thomas
Rocha, Rudi
Type
Journal Article
Abstract
This paper studies the effects of a large-scale exit of doctors on population health outcomes, health production inputs, outputs, and health system adaptation in Brazil. Identification exploits the exogenous timing of the Cuban exit from municipalities that relied more versus less on Cuban doctors within the More Doctors Program. We find persistent reductions in the care of chronic diseases, while service utilization for conditions requiring immediate care, such as maternal-related services and infections, quickly recovered. Reductions in utilization did not translate into changes in health outcomes. Supply-side response and demand diversion helped mitigate major adverse repercussions for population health at the market level.
Date Issued
2026-03-01
Date Acceptance
2025-12-19
Citation
Journal of Health Economics, 2026, 106
ISSN
0167-6296
Publisher
Elsevier BV
Journal / Book Title
Journal of Health Economics
Volume
106
Copyright Statement
Copyright © 2026 Elsevier B.V. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Publication Status
Published
Article Number
103099
Date Publish Online
2026-01-05