Management of Health Care Facilities and Patient Attendance during Major Disruptions: Evidence from Kenya, NBER Working Paper 35223, links a management survey with administrative data. The May 2026 study covers 429 primary healthcare facilities and 73 hospitals and examines outpatient attendance during disruption that included COVID-19 and a public health workers’ strike.

The authors report that attendance fell overall. Private facilities experienced a smaller decline than public facilities, consistent with substitution during the strike. Within the private sector, stronger management was associated with greater resilience, particularly in operations management. These are setting-specific findings; they do not establish that a management intervention caused an employer’s healthcare costs to fall.

Ask how the network responds to disruption This editor recommends that benefits purchasers examine the operating arrangements behind a provider network. A list of facilities does not explain how members obtain care when a service becomes unavailable. The review can identify who monitors an interruption, how alternatives are communicated and which organisation coordinates an unresolved access problem.

Providers should be able to describe the process using examples relevant to the employer’s locations and services. The team should distinguish a contingency plan from evidence that the plan has been tested. It can request information about responsibility, communication and review arrangements without assuming that a finding from Kenya transfers automatically to another healthcare system.

Evaluate continuity as a service question The employer can define what evidence would help it assess continuity. Reporting might identify an interruption, the action taken and whether a member’s access issue was resolved. The measures selected should have agreed definitions and an appropriate privacy process. An attendance measure is different from a clinical outcome, and each should be interpreted according to the question it addresses.

This editor recommends involving local benefits teams in that review. They can help explain how insured services interact with public care and where the organisation’s provider responsibilities begin and end. A global reporting framework should preserve those differences rather than hide them in a single comparison that cannot be interpreted locally.

The study offers a focused reason to look at management and operations alongside network size. For employers, its practical application is a review of their own continuity arrangements, followed by a documented plan for addressing identified gaps and checking whether the response works when services are interrupted.

Sources: Source primaire ou référence du sujet