The Impact of Subsidized Health Insurance on Access, Utilization and Health Status in Colombia

Abstract

This study examines the effects of Colombia's subsidized health insurance program on health outcomes, access and health care utilization of the poor. Propensity score matching is used to correct for observable differences between individuals who are affiliated and those who are not affiliated with the program. A matched difference-in-differences analysis is also applied to assess whether unobserved characteristics might bias results. Both methods consistently indicate that the subsidized health insurance scheme improves access and utilization of health services, especially among the rural and the poorest populations. Compared to similar people without insurance, the insured are 38% more likely to receive care when needed and 40% more likely to have used ambulatory services in the last 12 months. The share of women with professionally attended births is about five percent higher among those with subsidized insurance, and the share of children with complete immunization is also about five percent higher when they have subsidized insurance. The impact of health insurance on health status is inconclusive because the available surveys contain very few health status variables, and those that are measured are unlikely to be influenced by the services included in the subsidized insurance benefits package.