What happens to population health when the doctors leave? Evidence from the exit of Cuban doctors in Brazil
Journal of Health Economics · 2026 · Stefan Sliwa Ruiz、Malte Becker、Thomas Hone、Rudi Rocha
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.