Doctor Turnover and Health Outcomes: Evidence from the Exit of Cuban Doctors in Brazil

This paper studies the effects of a large-scale doctor turnover on health care utilization, health outcomes, and health system inputs in Brazil. Identification relies on an unexpected massive exit and replacement of doctors in affected municipalities. We find a strong and persistent decrease in the care of chronic diseases, while service utilization for conditions requiring immediate care, such as infections, recovered quickly throughout the turnover period. The reduction in service utilization did not translate into any changes in health outcomes. Adaptation of local health systems and demand diversion helped mitigate turnover effects without major immediate adverse repercussions for population health.