Bowser Diana M, Agarwal-Harding Priya, Ruscitti Brielle, Shepard Donald S, Harker Roa Arturo
William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.
The Heller School of Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA.
Health Syst Reform. 2025 Dec 31;11(1):2510769. doi: 10.1080/23288604.2025.2510769. Epub 2025 Jun 9.
The Venezuelan humanitarian crisis has led to the displacement of over 7.7 million migrants, with Colombia hosting around one-third. Colombia has been praised for its progressive policies for Venezuelan migrant integration, and the government's (ETPMV), introduced in February 2021, provides one of the region's most comprehensive regularization policies, permitting 10 years of residency and access to social protection services, including health insurance. We assessed the impact of the ETPMV on self-reported health insurance enrollment and formal healthcare utilization using two telephone surveys with 4,423 female Venezuelan migrants in 2020 and 2023. We used a difference-in-differences methodological approach, accounting for differences in levels of migrant health system integration across municipalities measured by a municipal enrollment index derived from secondary data. We find that the ETPMV significantly increases health insurance enrollment for female Venezuelan migrants and that while uninsured individuals experience a significant decline in healthcare utilization from 2020 to 2023, insured individuals experience no significant change. Additionally, the effect of insurance varies by municipal enrollment index, with greater impacts of insurance in areas with lower levels of regularization and health insurance enrollment. These results highlight the success of ETPMV in enhancing access to healthcare for Venezuelan migrants, with insurance enrollment providing a protective effect against declines in healthcare utilization compared to uninsured individuals. These findings underscore the importance of comprehensive regularization policies to address migrant health needs, while emphasizing the importance of continued efforts toward integration.
委内瑞拉的人道主义危机导致超过770万移民流离失所，其中约三分之一在哥伦比亚。哥伦比亚因其促进委内瑞拉移民融入的进步政策而受到赞誉，该国政府于2021年2月推出的《委内瑞拉移民和难民全面保护与融入法》（ETPMV）提供了该地区最全面的正规化政策之一，允许10年的居留权并可获得包括医疗保险在内的社会保护服务。我们通过对2020年和2023年4423名委内瑞拉女性移民进行的两次电话调查，评估了《委内瑞拉移民和难民全面保护与融入法》对自我报告的医疗保险参保率和正规医疗服务利用情况的影响。我们采用了差分法的方法，考虑了通过从二手数据得出的市政参保指数衡量的各城市移民卫生系统融入水平的差异。我们发现，《委内瑞拉移民和难民全面保护与融入法》显著提高了委内瑞拉女性移民的医疗保险参保率，而且虽然未参保者在2020年至2023年期间医疗服务利用率大幅下降，但参保者的医疗服务利用率没有显著变化。此外，保险的效果因市政参保指数而异，在正规化和医疗保险参保水平较低的地区，保险的影响更大。这些结果凸显了《委内瑞拉移民和难民全面保护与融入法》在增加委内瑞拉移民获得医疗服务机会方面的成功，与未参保者相比，参保为防止医疗服务利用率下降提供了保护作用。这些发现强调了全面正规化政策对于满足移民健康需求的重要性，同时强调了持续努力促进融合的重要性。
