Gender diversity and health system: An analysis on a sample of Italian companies

Journal title MECOSAN
Author/s Giovanni Bronzetti, Maurizio Rija, Graziella Sicoli, Dominga Anna Ippolito
Publishing Year 2022 Issue 2021/120
Language Italian Pages 19 P. 63-81 File size 225 KB
DOI 10.3280/MESA2021-120005
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The work analyzes the extent to which gender diversity is part of current health care practices. Through a statistical- inferential analysis on a sample of 39 hospitals belonging to the San Donato Group, it aims to assess whether the presence of women on the Board influences the business performance. The results suggest that diversity in healthcare organizations is a little explored issue and there is no shortage of opportunities and obstacles to women’s career paths. The correlation and regression analysis confirms that the presence of women is positively correlated with the performance index of companies; the road to achieving gender equality is not short and involves a redesign and improvement of health care companies organization which must open more the Boards to women.

Keywords: gender diversity, health agencies, Board of Directors, performance.

  1. American College of Healthcare Executives (2018). A comparison of the career attainments of men and women healthcare executives. – Retrieved from
  2. Amore M.D., Garogalo O. (2016). Executive gender, competitive pressures, and corporate performance. Journal of Economic Behavior & Organization, 131: 308-327.
  3. Athanasopoulou A., Moss-Cowan A., Smets M., Morris T. (2018). Claiming the corner office: Female CEO careers and implications for leadership development. Human Resource Management, 57(2): 617-639.
  4. Atkins B. (2018). Where did all the female CEOs go?. – Retrieved from
  5. Bart C., McQueen G. (2013). Why women make better directors?. International Journal of Business Governance and Ethics, 8: 93-99. DOI: 10.1504/IJBGE.2013.052743
  6. Ben-Amar W., Francoeur C., Hafsi, T., Labelle R. (2013). What makes better board? A closer look at diversity and ownership. British Journal of Management, 24(1).
  7. Bonn I., Yoshikawa T., Phan P.H. (2004). Effects of board structure on firm performance: a comparison between Japan and Australia. Asian Business & Management, 3(1): 105-125.
  8. Bourez V. (2005). Women on boards: Moving beyond tokenism. Journal of Business Ethics, 102(2): 299-317.
  9. Brieger S.A., Francoeur C., Welzel C., Ben-Amar W. (2017). Empowering Women: The Role of Emancipative Forces in Board Gender Diversity. Journal of Business Ehics.
  10. Brown D.A.H., Brown D.L., Anastasopoulos V. (2002). Women on Boards: Not just the Right Thing. But the “Bright” Thing. The Conference Board of Canada, Report, May, Ottawa.
  11. Campbell K., Mínguez-Vera A. (2008). Gender Diversity in the Boardroom and Firm Financial Performance. Journal of Business Ethics, 83(3).
  12. Carter D.A., Simkins B.J., Simpson W.G. (2003). Corporate Governance, Board Diversity and Firm Value. Financial Review, 38(1): 33-53. DOI: 10.1111/1540-6288.00034
  13. Dobbin F., Jung J. (2011). Corporate Board, Gender Diversity and Stock Performance: the Competence Gap or Institutional Investor Bias?. North Carolina Law Review, 89: 809-838, – available at:
  14. Doldor E., Sealy R., Vinnicombe S. (2016). Accidental activists: Head hunters as Marginal Diversity Actors in institutional change towards more women on boards. Human Resource Management Journal, 26: 285-303. DOI: 10.1111/1748-8583.12107
  15. Dwivedi P., Joshi A., Misangyi V.F. (2018). Gender-inclusive gatekeeping: How (mostly male) predecessors influence the success of female CEOs. Academy of Management Journal, 61(2): 379-404.
  16. Eagly A.H, Carli L.L. (2003). The female leadership advantage: an evaluation of the evidence, Leadership Quart, 14: 807-834.
  17. Eagly A.H., Karau S.J. (2002). Role congruity theory of prejudice toward female leaders. Psychological Review, 109: 573-598.
  18. Egon Z. (2018). Global Board Diversity. Tracker (GBDT).
  19. Erhardt N.L., Werbel J.D., Shrader C.B. (2003). Board of Director Diversity and Firm Financial Performance. Corporate governance: An International Review. European (PWN 2009), Board Women Monitor. DOI: 10.1111/1467-8683.00011
  20. Fernandez-Fejoo B., Romero S., Ruiz S. (2012). Does board gender composition affect corporate social responsability reporting?. International Journal of Business and Social Science, 3(1): 31-38. – Retrieved from
  21. Fernandez R.M., Campero S. (2017). Gender sorting and the glass ceiling in high-tech firms. ILR Review, 70(1): 73-104. DOI: 10.1177/0019793916668875.
  22. Fooladi M. (2012). Board Characteristic and Firm Performance. Journal of Modern Accounting and Auditting, 8(5): 688-694.
  23. Francoeur C., Labelle R., Sinclair-Desgagne B. (2008). Gender Diversity in Corporate Governance and Top Management. Journal of Business Ethics, 81(1): 83-95.
  24. Gabaldon P., De Anca C., Mateos de Cabo R. (2016). Searching for women on boards: An analysis from the supply and demand perspective, Corporate Governance: An International Review.
  25. Galstian C., Hearld L., O’Connor S.J., Borkowski N. (2018). The Relationship of Hospital CEO Characteristics to Patient Experience Scores. Journal health management, 63(1): 50-61. DOI: 10.1097/JHM-D-16-00020
  26. Ganiyu R.A., Oluwafemi A., Ademola A.A., Olatunji O. (2018). The glass ceiling conundrum: Illusory belief or barriers that impede women’s career advancement in the workplace. Journal of Evolutionary Studies in Business, 3(1): 137-166.
  27. Gao H., Lin Y., Ma Y. (2016). Sex discrimination and female top managers: Evidence from China. Journal of Business Ethics, 138(4): 683-702.
  28. Gaspoz J.M., Junod Peron N. (2011). Le futur sera interprofessionnel ou ne sera pas!. Revue Médical Svisse, 7(310): 1843-1844, – available from
  29. Grant T. (2019). An instinct for growth. Women in business: building a blueprint for action.
  30. Gregory‐Smith I., Main B.G., O’Reilly III C.A. (2014). Appointments, pay and performance in UK boardrooms by gender. The Economic Journal, 124(574): F109-F128.
  31. Grosvold J., Brammer S. (2011). National institutional systems as antecedents of female board representation: An empirical study. Corporate Governance: An International Review, 19: 116-136.
  32. Hillman A.J., Shropshire C., Cannella A.A. Jr. (2007). Organizational predictors of women on corporate boards. Academy of Management Journal, 50(4): 941-952.
  33. Huse M., Solberg A.G. (2006). Gender-related boardroom dynamics: How Scandinavian women make and can make contributions on corporate boards. Women in Management Review, 21(2): 113-130. DOI: 10.1108/09649420610650693.
  34. Huse M., Hoskisson R., Zattoni A., Viganò R. (2011). New perspectives on board research agenda. Journal of Management and Governance, 15(1): 5-28.
  35. Kachel S., Steffens M. C., Niedlich C. (2016). Traditional masculinity and femininity: Validation of a new scale assessing gender roles. Frontiers in Psychology, 7: 1-19.
  36. Kim D., Starks L.T. (2016). Gender diversity on corporate boards: Do women contribute unique skills?. American Economic Review, 106: 267-271.
  37. Konrad A.M., Kramer V.W., Erkut S. (2006). How many women do boards need?. Harvard Business Review, 84(12): 12-22.
  38. Joshi A., Roh H. (2009). The role of context in work team diversity research: a meta-analytic review. Academy of Management Journal, 52(3): 599-627.
  39. Lešetický O., Hajdikova T., Komarkova L., Pirozek P. (2016). Gender diversity in the management of hospitals in Czech Republic. In: D. Vasilenko, N. Khazieva. Atti della 4a conferenza su Management, Leadership e Governance. San Pietroburgo (Russia): ACPI UK, pp. 202-209.
  40. Lincoln A., Adedoyin O. (2012). Corporate governance and gender diversity in Nigerian boardrooms. World Academy of Science, Engineering and Technology, 71: 1853-1859, – available at:
  41. Mahadeo J.D., Soobaroyen T., Hanuman V.O. (2012). Board composition and financial performance: Uncovering the effects of diversity in an emerging economy. Journal of Business Ethics, 105: 375-388.
  42. Marinova J., Platenga J., Remery C. (2010). Gender Diversity and Firm Performance. Tjalling C. Koopmans Research Institute, Discussion Paper Series n. 10.
  43. Melero E. (2011). Are work places with many women in management run differently?. Journal of Business Research, 64(4).
  44. Miller T., Triana M.C. (2009). Demographic diversity in the boardroom: Mediators of the board diversity-firm performance relationship. Journal of Management Studies, 46(5): 755-786.
  45. Mirza H.H., Andleeb S., Ramzan F. (2012). Gender diversity and firm performance: Evidence from Pakistan. Journal of Social and Development Sciences, 3(5).
  46. Monaci M., Zanfrini L. (2014). Creare valore con la diversità. Sociologia del lavoro, 134.
  47. Mousa M. (2018). The effect of cultural diversity challenges on organizational cynicism dimension: A study from Egypt. Journal of Global Responsibility, 9(3). DOI: 10.1108/JGR-06-2017-0037.
  48. Nielsen S., Huse M. (2010a). The contribution of women on boards of directors: Going beyond the surface. Corporate Governance: An International Review, 18(2): 136-148.
  49. Nielsen S., Huse M. (2010b), Women directors contribution to board decision-making and strategic involvement: the role of equality perception. European Management Review, 7(1): 16-29.
  50. Oxelheim L. (2006). A Nordic perspective of Corporate Board Diversity. Nordic Innovation Centre: Norway.
  51. Palvia A., Vahamaa E., Vahamaa S. (2015). Are female CEOs and chairwomen more conservative and risk averse? Evidence from the banking industry during the financial 129 crisis. Journal of Business Ethics, 131: 577-594.
  52. Pande A., El Shalakani A., Hamed A. (2017). How can we measure progress on social justice in health care?. The case of Egypt. Health System & Reform, 3(1). DOI: 10.1080/23288604.2016.1272981
  53. Peterson C.A., Philpot J. (2007). Women’s roles on U.S. Fortune 500 boards: Director Expertise and Committee Memberships. Journal of Business Ethics, 72: 177-196.
  54. Post C. (2015). When is female leadership an advantage? Coordination requirements, team cohesion, and team interaction norms. Journal of Organizational Behavior, 36: 1153-1175.
  55. Randøy T. et al. (2006). A Nordic Perspective on corporate board diversity. Stockholm.
  56. Rao K., Tilt C. (2016). Board composition and corporate social responsibility. The role of diversity, gender, strategy and decision making. Journal of Business Ethics, 138(2): 327-347.
  57. Rapporto Cerved PMI (2018). Rotary Srl.
  58. Rapporto OASI (2019). Osservatorio sulle aziende e sul sistema sanitario italiano. Collana Cergas. Bocconi.
  59. Reinert R.M., Weigert F., Winnefeld C. H. (2016). Does female management influence firm performance? Evidence from Luxembourg banks. Financial Markets and Portfolio Management, 30(2): 113-136.
  60. Ridgeway C.L. (2001). Gender, status, and leadership. Journal of Social Issues, 57(4): 637-655. DOI: 10.1111/0022-4537.00233.
  61. Rizotti D., Frisenna C. (2017). Do Women Behave More Ethically Than Men? Evidence from the Impact of Women CEO on the Level of Earings Management, Paper presentato al XXXVIII Convegno Nazionale AIDEA Tendenze nuove negli studi economico-aziendali. L’evoluzione dei rapporti azienda-società, Roma, 14-15 settembre.
  62. Roberson Q.M., Park H. (2007). Examining the Link Between Diversity and Firm Performance. Group & Organization Management, 32(5): 548-568. DOI: 10.1177/1059601106291124.
  63. Rose C. (2007). Does female board representation influence firm performance? The Danish Evidence. Corporate Governance: An Iinternational Review, 15(2): 404-13.
  64. Rose C., Munch-Madsen P., Funch M. (2013). Does Board Diversity Really Matter? Gender does not, but citizenship does. International Journal of Business Science and Applied management, – available at:
  65. Russell M.S., Krentz M., Abouzahr K., Doyle M. (2019). Women dominate health care – just not in the executive suite, BCG.
  66. Sabharwal M. (2013). From Glass Ceiling to Glass Cliff: Women in Senior Executive Service. Journal of Public Administration Research and Theory, 25(2).
  67. Sheridan A., Ross-Smith A., Lord L. (2014). Institutional influences on women’s representation on corporate boards: An Australian case study. Equality, Diversity and Inclusion, 33. DOI: 10.1108/EDI-05-2013-0029.
  68. Shrader C.B., Blackburn V., Iles P. (1997). Women in management and firm financial performance: An exploratory study. Journal of Management Issues, 9(3): 355-372. – Retrieved from
  69. Skaggs S., Stainback K., Ducan P. (2012). Shaking things up or business as usual? The influence of female corporate executives and board of directors on women’s managerial representation. Social Science Research, 41(4): 936-948.
  70. Singh V., Vinnicombe S., Terjeen S. (2006). Women advancing onto the corporate board. In: Bilmoria D., Piderit K.S. (Eds). Handbook on Women in Business and Management. Cheltenham: Edward Elgar, pp. 304-329.
  71. Soklaridis S., Kuper A., Whitehead C.R., Ferguson G., Taylor V.H., Zahn C. (2017). Gender bias in hospital leadership: A qualitative study on the experiences of women CEOs. Journal of Health Organization and Management, 31(2): 253-268.
  72. Song P.H, Lee Y.D., Toth M., Singh S.R., Young G.J. (2019). Gender differences in hospital CEO compensation: a national investigation of not-for-profit hospital. Medical Care Research and Review, 76(6): 830-836. DOI: 10.1177/1077558718754573.
  73. Stahl G.K., Maznevski M.L., Voigt A., Jonsen K. (2010). Unraveling the effects of cultural diversity in teams: A metaanalysis of research on multicultural work groups. Journal of International Business Studies, 41(4): 690-709.
  74. Tacheva S., Huse M. (2006). How do women directors influence board effectiveness?. Best Paper Proceedings, Corporate Governance Track (EURAM). European Academy of Management Conference, Oslo.
  75. Tsugawa Y., Jena A.B., Figueroa J.F., Orav E.J., Blumenthal D.M., Jha A.K. (2017). Comparison of hospital mortality and read mission rates for medicare patients treated by male vs female physicians. Jama Internal Medicine, 172(2): pp. 206-2013.
  76. Vanderbroeck P., Wasserfallen J.B. (2017). Managing gender diversity in healthcare: getting in right. Leadership in Health Services, 30(1).
  77. Van Knippenberg D., De Dreu C.K.W., Homan A.C. (2004). Work group diversity and group performance: an integrative model and research agenda. Journal of Applied Psychology, 89(6): 1008-1022. DOI: 10.1037/0021-9010.89.6.1008.
  78. Van der Walt N., Ingley C. (2003). Board dynamics and the influence of professional background, gender and ethnic diversity of directors. Corporate Governance:An International Review, 11(3): 218-234. DOI: 10.1111/1467-8683.00320.
  79. Wallis C.J., Ravi B., Coburn N., Nam R.K., Detsky A.S., Satkunasivam R. (2017). Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ, 359: j4366.
  80. Watson W.E., Kumar K., Michaelsen L.K. (1993). Cultural diversity’s impact on interaction process and performance: comparing homogeneous and diverse task groups. Academy of Management Journal, 36(3): 590-602. DOI: 10.2307/256593.
  81. Wellage N.H., Locke S. (2013). Corporate governance, board diversity and firm financial performance. International Journal of Business Governance and Ethics, 8(2): 116-136.
  82. World Economic Forum (2018). The Global Gender Gap Report. World Economic Forum –
  83. Zhuwao S., Ngirande H., Ndlovu W., Setati S.T. (2019). Gender diversity, ethnic diversity and employee performance in a south African higher education institution. SA Journal of Human Resource Management, 17(0).
  84. Hogg M.A. (2006). Social identity theory. In: Burke P.J. (Eds). Contemporary Social Psychology Theories. Stanford, CA: Stanford University Press, pp. 111-136.
  85. Adams R.B., Ferreira D. (2009). Women in the Boardroom and their Impact on Governance and Performance. Journal of Financial Economics, Baranchuck and Dybvig.
  86. Adams R.B., Hermalin B.E., Weisbach M.S. (2010). The role of boards of directors in corporate governance: A conceptual framework and survey. Journal of Economic Literature, 48(1): 58-107.
  87. Ali J., Shabir S. (2017). Does gender make a difference in business performance? Evidence from a large enterprise survey data of India, Gender in Management: An International Journal, 32(3): 218-233. DOI: 10.1108/GM-09-2016-0159.
  88. American College of Healthcare Executives (2012). A comparison of the career attainments of men and women healthcare executives. Chicago, IL: Foundation of the American College of Healthcare Executives. – Retrieved from
  89. American College of Healthcare Executives (2016). Hospital CEO turnover rate remains elevated. – Retrieved from
  90. Casarico A., Profeta P., Salvadori L. (2009). Donne al vertice delle imprese e azioni positive. Short note n. 7, Econpubblica – Centre for Reasearch on the Public Sector, Università Bocconi.
  91. Catalyst (2011). The Bottom Line: Corporate Performance and Women’s Representation on Boards (2004-2008). New York.
  92. Connley C. (2019). The number of women running Fortune 500 companies is at a record high. – Retrieved from
  93. Conyon M.J., He L. (2017). Firm Performance and Boardroom Gender Diversity: A Quantile Regression Approach. Journal of Business Research, 79: 198-211.
  94. Cook A., Glass C. (2014). Women and top leadership positions: Towards an institutional analysis. Gender, Work & Organisation, 21(1): 91-103. DOI: 10.1111/GWAO.12018
  95. Delaney R., Strough J., Parker A.M., de Bruin W.B. (2015). Variations in decision-making profiles by age and gender: A cluster-analytic approach. Personality and Individual Differences, 85: 19-24.
  96. Dezsö C.L., Ross D.G. (2012). Does female representation in top management improve firm performance? A panel data investigation. Strategic Management Journal, 33(9): 1072-1089. DOI: 10.1002/SMJ.1995.
  97. Dhir A.A. (2015). Challenging boardroom homogeneity: Corporate law, governace and diversity. Cambridge: Cambridge University Press.

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