Marvin O'Quinn, chief executive of Jackson Health System, resigned Friday to accept a top job with Catholic Healthcare West, a system of more than 40 hospitals.

''While I am saddened to be leaving Jackson, my wife and I look forward to being closer to our family members, many of whom live out West,'' O'Quinn wrote in a letter to employees.

O'Quinn, 56, was praised by leaders of the Public Health Trust, which supervises Jackson. They said O'Quinn took over a money-losing system and made it financially steady at a time when other public hospitals have been struggling to survive.

They said his absence will be felt as the system faces stiff challenges confronting all public hospitals in a down economy: increasing numbers of uninsured unable to pay for care while tax revenue shrinks.

''I think we're going to miss him,'' said Miami-Dade Commissioner Javier Souto, a trust board member. He said he and O'Quinn had discussed the system's plight at length recently, with the hospital exec pulling out pie charts to make his point. The underlying theme: It won't be the same hospital in five years.

''In the past, monies came from the state. The federal government would also come to the rescue,'' said Souto. Now both governments have strained resources and are unlikely to offer increased support.

O'Quinn was head of Jackson for five years, taking over when it had an $85 million annual loss and finishing with a surplus the following year. Among his major actions was buying Parkway Regional Medical Center, which became Jackson North.

His new job will be executive vice president/chief operating officer with the Catholic group, which is based in San Francisco and operates hospitals in California, Arizona and Nevada. O'Quinn will remain with Jackson through December. His salary at Jackson is $826,967.

O'QUINN UNAVAILABLE

O'Quinn was not available for an interview Friday, said Jackson spokesman Robert Alonso.

O'Quinn was picked to be Jackson's chief executive after a national search. His career has spanned 30 years, starting as a hospital orderly and rising to top positions at New York City and New Jersey hospitals before coming to Miami.

''He's going to be greatly missed,'' said Ernesto A. de la Fé, chairman of the trust board. ''I tried on many occasions to convince him to stay, but it was really a personal decision to be close to family members.'' He said the board would meet soon to decide how to conduct a search for his replacement. Two other board members, Rosy Cancela and Armando Gutierrez Jr., said they, too, were sorry to see him go.

University of Miami President Donna Shalala called O'Quinn ''a man of high integrity and intelligence. . . . His is a huge loss for the university and for healthcare in our community.'' Jackson Memorial serves as the teaching hospital for the UM medical school.

Pascal Goldschmidt, dean of the med school, said he was ``saddened by the departure. Marvin has been a friend and a really wonderful colleague. . . . There was no double-face talk with him. It was frank talk.''

O'Quinn and members of the health trust had expressed considerable concern in 2007 when UM purchased Cedars Memorial hospital, right across the street from Jackson Memorial, fearing it might draw paying patients away from Jackson.

But that apparently didn't happen. In fiscal 2007, ending Sept. 30, before UM took over Cedars, Jackson reported a loss of $34 million on revenue of $1.7 billion.

ALMOST BREAKING EVEN

Audited figures for fiscal 2008, which ended less than two weeks ago, are not available, but de la Fé said it looks like the hospital will come close to breaking even or have a small loss.

Any loss has been greatly reduced by strong taxpayer support. In 2007, the half-penny sales tax for public healthcare brought in $190.9 million, and county property taxes contributed another $160.7 million to the system.

This year, it's estimated that the sales tax will again bring in about $190 million. The county agreed to give Jackson $177.9 million, and it authorized the system to get another $45 million in a loan from the state.

As the economy worsens, the pressure for support is likely to get stronger, said Souto and de la Fé. Public hospitals in Atlanta and Chicago have struggled for survival. While Jackson is not in danger of going under, its financial future looks rough.

''We are facing challenging times,'' said de la Fé. With a declining economy, ''more people will lose their jobs and lose their insurance,'' which means they are likely to show up at Jackson, the county's safety net for healthcare. Tax revenue is also likely to decline as sales and home prices go down.

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