RESEARCH AREAS: Applied Microeconomics (discrimination, incentive, information), Health Economics, Development Economics.
JOB MARKET PAPER:
Kovacs, R & Powell-Jackson, T. (2026). Gender-based discrimination in healthcare: Audit-study evidence from Kenya.
SELECTED PUBLICATIONS:
ECONOMICS:
Kovacs, R. (2025). Does free maternity care improve access and save lives? Quasi-experimental evidence from Kenya. World Development.
Kovacs, R., Dunaiski, M., Glizzi, M., Hortala-Vallve, R., Murtin, F. (2024) The determinants of trust: findings from large, representative samples in six OECD countries. Economica.
Kovacs, R., Dunaiski M., Tukiainen, J. (2023) Compulsory face mask policies do not affect community mobility in Germany. The Scandinavian Journal of Economics.
Kovacs, R. , Lagarde, M. (2022) Does high workload reduce the quality of healthcare? Evidence from rural Senegal. Journal of Health Economics.
Kovacs, R. , Lagarde, M., & Cairns, J. (2022). Can patients improve the quality of care they receive? Experimental evidence from Senegal. World Development.
Kovacs, R. , Lagarde, M., & Cairns, J. (2020). Overconfident health workers provide lower quality healthcare. Journal of Economic Psychology.
Kovacs, R., Lagarde, M., & Cairns, J. (2019). Measuring patient trust: Comparing measures from a survey and an economic experiment. Health Economics.
PUBLIC HEALTH AND HEALTH POLICY:
Kovacs, R. (2026). Public Vs. Private: the Quality of Ante-natal Care in Resource-poor Settings. PLOS Public Health.
Ellegård, L. M., Kjellsson, G., Kovacs, R., Zhao, Y. (2025) Patient choice and socioeconomic disparities in the quality of healthcare: Evidence from Swedish registry data. Social Science & Medicine.
Kovacs, R. , Barreto, J., Nunes da Silva, E., et al. (2021). Socioeconomic inequalities in the quality of primary care under Brazil’s national pay-for-performance programme: a longitudinal study of family health teams. The Lancet Global Health.
Wiseman, V., Lagarde, M., Kovacs, R., et al., (2019). Using unannounced standardised patients to obtain data on quality of care in low-income and middle-income countries: Key challenges and opportunities. BMJ Global Health.
Kovacs, R. (2017). The macro-level drivers of intimate partner violence: New evidence from a multilevel dataset. Global Public Health.
WORKING PAPERS:
Kovacs, R., Abuya Y., Powell-Jackson, T. (2026). Rationing under Excess Demand: Evidence on Providers’ Adjustment Margins.
Excess demand is pervasive in public service delivery and, when absorbed at the point of provision, is widely believed to impair provider performance. However, the welfare consequences of excess demand depend critically on how providers allocate scarce capacity. We study how healthcare providers clear excess demand and develop a simple framework that distinguishes three primary adjustment margins: rationing through waiting, quality rationing along the intensive margin and quality rationing along the extensive margin. Using rich micro-data from 1,326 unannounced standardised patient visits to primary care facilities in Nairobi, we estimate the effect of workload on provider behaviour, exploiting quasi-random within-facility variation in demand -- arising from pre-specified visit timing. We show that waiting times rise sharply during periods of excess demand, while effort, quality, and access remain unchanged. These precisely estimated null effects rule out intensive and extensive-margin rationing even at the highest levels of workload and among providers with sufficient clinical knowledge -- suggesting that rationing through waiting is the dominant adjustment margin. We examine mechanisms underlying this null and find evidence consistent with fixed routines -- providers delivering a similar package of care regardless of workload -- which suggests that quality gains from reducing workload are likely limited.
Kovacs, R., Powell-Jackson, T., Hone, T., Barreto, J., Nunes da Silva, E. Paying our way to better health? The impact of public spending on health outcomes in Brazil.
It remains unclear whether government can improve health outcomes by increasing public spending on health care. We study the effect of an increase in public spending on primary care on health care-seeking and mortality in Brazil, using an event study difference-in-differences design that covers 5,443 municipalities over 11 years. We exploit the staggered introduction of a national programme called PMAQ that increased public spending on primary care by 6% in participating municipalities. Results suggest that this substantial increase in public spending did not translate into better health on average, with coefficients precisely estimated around zero. We examine a number of potential explanations for the null finding, including corruption and the spending increase being too small. We find that the effect of public spending on health outcomes is moderated by the level of local development, as public spending only reduces mortality in wealthy municipalities.
ONGOING PROJECTS
Parents’ mental health: Using rich Swedish registry data, I study the economics of parental mental health and evaluate social policy and healthcare interventions aimed at prevention. I estimate (i) the causal effect of a parental-leave reform increasing fathers’ involvement in childcare and (ii) the impact of talking-therapy provision on parents’ mental health, economic outcomes, and child wellbeing.
Mental health of healthcare providers: Using data from standardised patients in Kenya, I examine the link between providers’ mental health and the quality of care they deliver.