Journal of migration and health · 2025
Health for all? A cost-utility evaluation of Colombia's policy to enroll Venezuelan migrants (2021-2023).
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Espinosa Oscar, Rodríguez Paul, Bejarano Valeria, León Santiago, Ortiz José Luis
Аннотация
INTRODUCTION: From 2021 to 2023, Colombia implemented a national policy to expand health insurance coverage for over 1.4 million Venezuelan migrants through its subsidized health insurance system, which provides universal health coverage to low-income Colombian populations. This study evaluates the cost-utility of the intervention, focusing on its health and economic returns.
METHODS: We conducted a cost-utility analysis by translating government expenditure per enrolled migrant into health outcomes (QALYs/YLLs) using Colombia-specific cost-effectiveness thresholds. Health benefits were measured in quality-adjusted life years (QALYs) gained and years of life lost (YLLs) averted. Colombia-specific cost-effectiveness thresholds (CETs) were used to estimate outcomes, and an internal rate of return (IRR) analysis assessed the program's social profitability.
RESULTS: The intervention generated an estimated 10,259 QALYs gained or 11,843 YLLs averted between 2021 and 2023. The IRR reached 27.5% when QALYs were valued at 100% of Gross Domestic Product per capita, indicating strong social returns. Women and adults aged 19-44 showed the greatest health gains, with urban areas receiving the highest benefits. This evidence demonstrates that even health policies can yield high social returns, providing a model for other countries navigating large-scale migration.
DISCUSSION: Expanding subsidized health insurance to migrants proves to be a highly cost-effective policy. This analysis supports Colombia's approach as a scalable and impactful model for inclusive public health aligned with universal health coverage goals.
METHODS: We conducted a cost-utility analysis by translating government expenditure per enrolled migrant into health outcomes (QALYs/YLLs) using Colombia-specific cost-effectiveness thresholds. Health benefits were measured in quality-adjusted life years (QALYs) gained and years of life lost (YLLs) averted. Colombia-specific cost-effectiveness thresholds (CETs) were used to estimate outcomes, and an internal rate of return (IRR) analysis assessed the program's social profitability.
RESULTS: The intervention generated an estimated 10,259 QALYs gained or 11,843 YLLs averted between 2021 and 2023. The IRR reached 27.5% when QALYs were valued at 100% of Gross Domestic Product per capita, indicating strong social returns. Women and adults aged 19-44 showed the greatest health gains, with urban areas receiving the highest benefits. This evidence demonstrates that even health policies can yield high social returns, providing a model for other countries navigating large-scale migration.
DISCUSSION: Expanding subsidized health insurance to migrants proves to be a highly cost-effective policy. This analysis supports Colombia's approach as a scalable and impactful model for inclusive public health aligned with universal health coverage goals.