Disparities in healthcare-seeking behaviors and associated costs between Venezuelan migrants and Colombians residing in Colombia

Background

Colombia, which hosts over three million Venezuelan migrants, is recognised for extending access to its universal health coverage system. However, significant barriers to healthcare remain, and disparities in healthcare-seeking behaviours and associated costs are not well understood. This study is the first to link healthcare-seeking behaviours with direct and indirect costs for Venezuelan migrants in Colombia.

Methods

Researchers analysed self-reported survey data collected between September and November 2020 from Venezuelan migrants and Colombian nationals. Healthcare-seeking behaviours, disease profiles, and costs were compared using statistical tests. Direct costs were estimated through the Colombian Government’s Suficiencia database combined with out-of-pocket (OOP) payments for pharmacy and laboratory services. Indirect costs were calculated by combining self-reported days of missed work or usual activities with estimated income levels.

Results

Although disease burdens were similar, Venezuelan migrants were 21.3% more likely to forgo formal care than Colombians, with lack of health insurance overwhelmingly cited as the reason. Venezuelan women and the uninsured reported the greatest difficulties, with access to medicines worsening for women during the COVID-19 pandemic. Colombians generated higher average system costs per treated illness (US$40 compared to US$26 for migrants), but Venezuelans incurred higher OOP costs, including 123.5% more for emergency visits and 24.7% more for laboratory and pharmacy services.

Conclusions

While Colombians and Venezuelans share similar disease burdens, significant differences exist in access, cost, and health-seeking behaviors. Increasing Venezuelan health insurance enrolment and tackling accessibility barriers are crucial for ensuring healthcare equity, and effectively integrating the migrant population. Findings suggest that improving migrant access to primary healthcare would produce savings in Colombian healthcare expenditures.

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