Rationing under Excess Demand: Evidence on Providers’ Adjustment Margins

Roxanne Kovacs (), Timothy Abuya and Timothy Powell-Jackson
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Roxanne Kovacs: Department of Economics, School of Business, Economics and Law, Göteborg University, Postal: P.O. Box 640, SE 40530 GÖTEBORG, Sweden

No 864, Working Papers in Economics from University of Gothenburg, Department of Economics

Abstract: Excess demand is pervasive in public service delivery, but its consequences depend on how providers allocate scarce capacity. We sent standardised patients – trained auditors posing as real patients – to 198 primary-care facilities in Nairobi. Across 1,326 pre-scheduled visits, we exploit within-facility variation in workload. We find that when queue length exceeds the typical daily workload per provider, waiting time is 21 minutes longer (0.4 SD). We find no reduction in consultation effort and no statistically significant deterioration in care quality or access. This suggests short-run congestion is borne primarily through users’ time and need not reduce service quality.

Keywords: Excess demand; Non-price rationing; Queuing; Congestion; Healthcare (search for similar items in EconPapers)
JEL-codes: D24 H51 I11 I18 (search for similar items in EconPapers)
Pages: 55 pages
Date: 2026-10
New Economics Papers: this item is included in nep-hea
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