Impact of COVID-19 on healthcare utilisation, cases, and deaths of citizens and displaced Venezuelans in Colombia

Colombia hosts 1.8 million displaced Venezuelans, the second highest number of displaced persons globally. Colombia’s constitution entitles all residents, including migrants, to life-saving health care, but actual performance data are rare. This study assessed Colombia’s COVID-era achievements.

This study compared utiliasation of comprehensive (primarily consultations) and safety-net (primarily hospitalisation) services, COVID-19 case rates, and mortality between Colombian citizens and Venezuelans in Colombia across 60 municipalities. Compared to Venezuelans, Colombians used vastly more comprehensive services than Venezuelans (608% more consultations), in part due to their 25-fold higher enrollment rates in contributory insurance. For safety-net services, however, the gap in utilisation was smaller and narrowed. From 2019 to 2020, Colombians’ hospitalisation rate per person declined by 37% compared to Venezuelans’ 24%. In 2020, Colombians had only moderately (55%) more hospitalisations per person than Venezuelans. From 2019 to 2020, Colombians’ age-adjusted mortality rate rose by 26% while Venezuelans’ rate fell by 11%, strengthening Venezuelans’ mortality advantage to 14.5-fold.

The contrasting patterns between comprehensive and safety net services suggest that the complementary systems behaved independently. Venezuelans’ lower 2019 mortality rate likely reflects the healthy migrant effect (selective migration) and Colombia’s safety net healthcare system providing Venezuelans with reasonable access to life-saving treatment. However, in 2020, Venezuelans still faced large gaps in utilisation of comprehensive services. Colombia’s 2021 authorisation of 10-year residence to most Venezuelans is encouraging, but additional policy changes are recommended to further integrate Venezuelans into the Colombian health care system.