The effect of a pilot universal health coverage program on hospital workload: A comparative study of two counties in Kenya.

Abstract

Universal health coverage (UHC) aims to provide individuals with the healthcare they need without predisposing them to catastrophic health expenditures. The Kenyan government piloted UHC in four select counties in 2019. Nyeri County was one of the selected counties. Area residents accessed health services from government-owned health facilities at no cost. This study assessed the effect of this pilot on the workload of major health facilities in Nyeri. The monthly workload of six health facilities in Nyeri was compared with that of similar facilities in the non-participating county of Embu. A difference-in - differences analysis was done for workload indicators. Workload was downloaded from the Kenya health information system. The level 5 hospital recorded an increase in eight workload indicators with four having statistically significant increases. Three indicators recorded non-significant declines. The level 4 and 3 health facilities also recorded an increase in outpatient workload. The pilot UHC program increased workload and by extension utilization of healthcare among major health facilities in Nyeri.