Scandinavian Working Papers in Economics
Working Papers in Economics,
University of Gothenburg, Department of Economics
No 864: Rationing under Excess Demand: Evidence on Providers’ Adjustment Margins
Roxanne Kovacs (), Timothy Abuya and Timothy Powell-Jackson
Additional contact information
Roxanne Kovacs: Department of Economics, School of Business, Economics and Law, Göteborg University, Postal: P.O. Box 640, SE 40530 GÖTEBORG, Sweden
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
Language: English
55 pages, October 2026
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RePEc:hhs:gunwpe:0864This page generated on 2026-10-13 11:53:00.