The objective of this research was to identify types of hospital governance in Latin America and to examine whether and how these governance types are associated with hospital performance. The authors also sought to explore hospital governance conceptually and contextually within national and international experience.

The research was based on survey of nearly 400 hospitals in Argentina, Brazil, Colombia and Mexico. The authors conducted a cluster analysis of the results identifying four governance types based on organizational elements theorized to affect hospital behavior:(1) budgetary unit of government;(2) autonomous unit of government;(3) corporate unit of a private conglomerate or broader, private hospital system; or lastly (4) a private and autonomous unit. These types were compared in five analyses:(a) administrators' ratings of their own hospital’s performance;(b) hospital performance indicators, such as occupancy and costs per bed;(c) performance tracking vis-à-vis standards;(d) ratings of criteria for selecting leadership; and (e) hospital administrators' qualifications.