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Reproducibility package for Public Externalities Of Universal Health Care Access

2026
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Reference ID
RR_COL_2026_718
Author(s)
Sandra V. Rozo, Tatiana Hiller, Leonardo Peñaloza-Pacheco
Collections
World Bank Policy Research Working Papers
Metadata
JSON
Created on
Sep 09, 2026
Last modified
Sep 09, 2026
Page views
28
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7
  • Project Description
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  • Overview

    Abstract

    Extending health coverage to excluded groups may change the health of everyone else who shares the same hospitals and budgets. In 2022, Colombia granted nearly two million Venezuelan migrants access to full health services. We explore the effects of this health care expansion on Colombian mortality rates, comparing municipalities more and less exposed to the program before and after the program’s mass rollout. In a program that covered nearly four percent of the population, we find that a one standard deviation increase in municipal exposure to the program, about 65 newly covered migrants per 1,000 inhabitants, reduced mortality among Colombians by 3.8 percent, with declines of 4.5 percent in infant mortality and 5.6 percent among adults 65 and older. The program averted roughly 6,000 deaths per year, about one life saved annually for every 325 migrants covered. These effects are driven by congestion relief. Newly insured migrants entered financed routine care at scale, tilting the composition of their care sharply away from emergency rooms, while Colombians’ own emergency visits fell and their routine care continued to expand, sustained by the scheduled flow of financial resources for legally covered migrants. Because emergency care was already publicly financed for undocumented migrants, full coverage increased net public spending only modestly. As a result, the net fiscal cost per Colombian life saved is at most USD $63,000, well below conventional benchmarks based on the value of a statistical life. These are benefits for an already insured host population, a channel that is generally omitted from standard fiscal estimates of expanding health coverage to excluded populations.

    Reproducibility Package

    Scripts
    Readme Get Reproducibility Package
    Link: https://reproducibility.worldbank.org/catalog/650/download/1956/README.pdf
    Reproducibility package for Public Externalities Of Universal Health Care Access
    File name
    RR_COL_2026_718
    Zip package
    RR_COL_2026_718.zip
    Title
    Reproducibility package for Public Externalities Of Universal Health Care Access
    Date
    2026-08
    Dependencies
    Stata dependencies are listed in the ado folder.
    Instructions
    See README in reproducibility package.
    Notes
    Computational reproducibility verified by Development Impact (DECDI) Analytics team, World Bank.
    Source code repository
    Repository name URI
    Reproducible Research Repository (World Bank) https://reproducibility.worldbank.org
    Software
    Stata
    Name
    Stata
    Version
    19.5 MP
    Python
    Name
    Python
    Version
    3.13

    Reproducibility

    Technology environment

    Paper exhibits were reproduced on a computer with the following specifications:

    • OS: Windows 11 Enterprise
    • Processor: INTEL(R) XEON(R) GOLD 6226R CPU @ 2.90GHz (2 processors
    • Memory: 16 GB
    Technology requirements

    Run time: ~20 minutes.

    Reproduction instructions

    To reproduce the findings in this paper, a replicator must:

    1. Secure Access to Data: Access the datasets not included in the package. See the Datasets section for more details.
    2. Run the Package: Update the working directory in line 29 of the do-file main, and run it.

    Since not all the data is included, the package includes the results produced by replicators. These files can be used to review the results presented in the paper.

    Data

    Datasets
    Registro Individual de Prestación de Servicios de Salud (RIPS)
    Name
    Registro Individual de Prestación de Servicios de Salud (RIPS)
    Note
    Files location: rips_data/rips_detailed_panel.csv. Migrant health-service encounters by municipality × month × document type × care type. rips_data/rips_colombian_panel.csv. Colombian citizens' service utilization by municipality × month × care type. rips_data/rips_disease_unified_panel.csv. RIPS diagnoses grouped into disease categories; used only for the chronic-care aggregate rips_dis_m.dta. Aggregated by agg_disease.py; the resulting non-confidential aggregate ships as usable data. Replicators should request to MinSalud for SISPRO cube access. The aggregated cubes are reachable at https://www.sispro.gov.co once credentials are issued; the municipality-by-month extracts we use are produced from those cubes. Contact: correo@minsalud.gov.co (official correspondence address). Acknowledgements are issued by notificaciones_sgdea@minsalud.gov.co. Alternative route: a derecho de petición under Article 23 of the Colombian Constitution and Law 1755 of 2015, sent to the same address. MinSalud returns a radicado number and must answer within fifteen business days. Replicators outside Colombia may need a Colombian host institution. Individual-level records are not released; the municipal aggregates used in this package are.
    Access policy
    Data access was granted directly to the study authors by the data owners/managers. It was obtained with a custom data license that does not allow for redistribution and it is not included in the reproducibility package.
    Data URL
    https://www.sispro.gov.co
    Citation
    Ministerio de Salud y Protección Social (MinSalud). Registro Individual de Prestación de Servicios de Salud (RIPS), via SISPRO [dataset]. https://www.sispro.gov.co. Access date: 2026.
    Estatuto Temporal de Protección para Migrantes Venezolanos (ETPV)
    Name
    Estatuto Temporal de Protección para Migrantes Venezolanos (ETPV)
    Note
    File location: ETPV_MunicipalityDATA.dta. ETPV registrations and PPT deliveries by municipality (the treatment measure). Replicators should access the PQRSDF portal: https://apps.migracioncolombia.gov.co/pqrs/home. Then, file the request as a derecho de petición de interés general. The portal issues a radicado immediately and the statutory window is fifteen business days. Replicators should also ask specifically for registrations and permits by DIVIPOLA municipality code and month. A request phrased by municipality name alone will return a name-keyed file, which cannot be merged safely because 67 Colombian municipality names are shared across departments.
    Access policy
    Data access was granted directly to the study authors by the data owners/managers. It was obtained with a custom data license that does not allow for redistribution and it is not included in the reproducibility package.
    Citation
    Unidad Administrativa Especial Migración Colombia. ETPV registrations and PPT deliveries by municipality [dataset]. Unpublished administrative data. Access date: 2026.
    Programa Ampliado de Inmunizaciones (PAI)
    Name
    Programa Ampliado de Inmunizaciones (PAI)
    Note
    File location: PAI/pai_vacunacion_panel.dta. Vaccine doses applied and programmatic targets by municipality × year × vaccine. Replicators should request to MinSalud for SISPRO cube access. The aggregated cubes are reachable at https://www.sispro.gov.co once credentials are issued; the municipality-by-month extracts we use are produced from those cubes. Contact: correo@minsalud.gov.co (official correspondence address). Acknowledgements are issued by notificaciones_sgdea@minsalud.gov.co. Alternative route: a derecho de petición under Article 23 of the Colombian Constitution and Law 1755 of 2015, sent to the same address. MinSalud returns a radicado number and must answer within fifteen business days. Replicators outside Colombia may need a Colombian host institution. Individual-level records are not released; the municipal aggregates used in this package are.
    Access policy
    Data access was granted directly to the study authors by the data owners/managers. It was obtained with a custom data license that does not allow for redistribution and it is not included in the reproducibility package.
    Data URL
    https://www.sispro.gov.co
    Citation
    Ministerio de Salud y Protección Social (MinSalud). Programa Ampliado de Inmunizaciones (PAI), PAIWEB via SISPRO [dataset]. https://www.sispro.gov.co. Access date: 2026.
    Estadísticas Vitales (EEVV)
    Name
    Estadísticas Vitales (EEVV)
    Note
    Files location: mortality/NO FETALES/nofetal*.dta, nofetal2021.csv. Catalogue entry "Estadísticas Vitales - Defunciones No Fetales", 2016 to 2024 evv_births/nacimientos_panel_municipio_mes.dta. DANE birth records, aggregated to municipality × month. Catalogue entry "Estadísticas Vitales - Nacimientos", annual files for 2016 to 2024. Individual birth records are collapsed to municipality of residence (cod_dpto_res, cod_mun_res) by month (anno, mes). The DANE microdata catalogue does not expose stable deep links to individual study pages; entries are reached by searching the catalogue and the study identifier changes between releases: https://microdatos.dane.gov.co
    Access policy
    Data is publicly available and included in the reproducibility package.
    License
    Public (Unrestricted)
    License URL
    https://www.dane.gov.co/index.php/servicios-al-ciudadano/tramites/transparencia-y-acceso-a-la-informacion-publica/terminos-y-condiciones
    Data URL
    https://microdatos.dane.gov.co
    Citation
    Departamento Administrativo Nacional de Estadística (DANE). Estadísticas Vitales (EEVV) [dataset]. www.dane.gov.co. Access date: 2026.
    Proyecciones de población
    Name
    Proyecciones de población
    Note
    Files location: population/DANE_proypoblacion_Mun_2020_2035.xlsx, population/DANE_retroproypoblacion_Mun_2005_2019.xlsx, population/DANE_pop_sexo_edad_Mun_2005_2019, population/DANE_pop_sexo_edad_Mun_2020_2035. Municipal population projections and retroprojections by age. The DANE microdata catalogue does not expose stable deep links to individual study pages; entries are reached by searching the catalogue and the study identifier changes between releases: : https://www.dane.gov.co , Demografía y Población, Proyecciones de Población, municipal series 2005 to 2019 (retroproyecciones) and 2020 to 2035.
    Access policy
    Data is publicly available and included in the reproducibility package.
    License
    Public (Unrestricted)
    License URL
    https://www.dane.gov.co/index.php/servicios-al-ciudadano/tramites/transparencia-y-acceso-a-la-informacion-publica/terminos-y-condiciones
    Data URL
    https://www.dane.gov.co
    Citation
    Departamento Administrativo Nacional de Estadística (DANE). Proyecciones y retroproyecciones de población municipal [dataset]. https://www.dane.gov.co. Access date: 2026.
    Panel Municipal Centro de Estudios sobre Desarrollo Económico
    Name
    Panel Municipal Centro de Estudios sobre Desarrollo Económico
    Note
    File location: cede/cede_master_panel.dta. Pre-shock municipal characteristics. CEDE distributes the panel as separate thematic modules, among them características generales, buen gobierno, educación, salud, agrícola, conflicto y violencia, and the fiscal series. The modules are merged on municipality code (codmpio) and year (ano) into one wide panel. Two bookkeeping variables survive from that merge and make it auditable: n_panels_present records how many source modules contributed to each municipality-year, and n_vars_nonmissing how many variables are populated. Replicators can access the data via: https://datoscede.uniandes.edu.co, Panel Municipal. Registration is required and free. File location: growth/Cleaning_PEP_colombia_adm2.dta. A municipality-by-year panel merging annual mean night-light density (light_mean, nl_meanyear*) with municipal revenue and expenditure aggregates (the y_* and g_* families, in levels, per capita and in logs) and baseline characteristics (poverty, NBI, Gini, urban share, population). This was assembled for the earlier PEP project, and it carries that project's treatment indicators (tpep, dtreatment, dtreat_post). The present paper uses the night-light and municipal fiscal series only, in the local-activity test reported in the mechanisms section.
    Access policy
    Data is publicly available and included in the reproducibility package.
    License
    CC0 1.0
    License URL
    https://creativecommons.org/publicdomain/zero/1.0/
    Data URL
    https://datahub.uniandes.edu.co/dataverse/uniandes_proyectos-de-investigacion_panel-municipal-CEDE
    Citation
    Centro de Estudios sobre Desarrollo Económico (CEDE), Universidad de los Andes. Panel Municipal CEDE [dataset]. https://datoscede.uniandes.edu.co. Access date: 2026.
    Gran Encuesta Integrada de Hogares (GEIH)
    Name
    Gran Encuesta Integrada de Hogares (GEIH)
    Note
    File location: growth/Cleaning_PEP_GEIH_adm2_2010_2024.dta. Labor-market cells built from the household survey. DANE, Gran Encuesta Integrada de Hogares (GEIH), person-level microdata pooled 2010 to 2024 (https://microdatos.dane.gov.co , entry "Gran Encuesta Integrada de Hogares"), merged with municipal covariates drawn from CEDE and from VIIRS night lights. GEIH person records retaining the survey identifiers (directorio, secuencia_p, orden, hogar), the demographic and labour variables (employment, hours, formality, contract type, earnings, industry and occupation codes, country of birth), and the survey weight, with the municipality code (adm2_pcode) attached. Pre-period municipal covariates are merged on: 2009 GDP per capita, 2005 poverty and NBI, 2010 theft and homicide rates, baseline night lights, and the 2010 urban share. The treatment variables carried in the file (dtreatment, dpost, post_cont_*, and the percentile variants dtreatp5 through dtreatp75) were constructed for the earlier PEP regularization project from which this file comes. The present package does not use them. It uses the labour variables and the municipality identifier only. File location: growth/Cleaning_PEP_colombia_adm2.dta. A municipality-by-year panel merging annual mean night-light density (light_mean, nl_meanyear*) with municipal revenue and expenditure aggregates (the y_* and g_* families, in levels, per capita and in logs) and baseline characteristics (poverty, NBI, Gini, urban share, population). This was assembled for the earlier PEP project, and it carries that project's treatment indicators (tpep, dtreatment, dtreat_post). The present package uses the night-light and municipal fiscal series only, in the local-activity test reported in the mechanisms section. The DANE microdata catalogue does not expose stable deep links to individual study pages; entries are reached by searching the catalogue and the study identifier changes between releases: https://microdatos.dane.gov.co , "Gran Encuesta Integrada de Hogares", annual files 2010 to 2024.
    Access policy
    Data is publicly available and included in the reproducibility package.
    License
    Public (Unrestricted)
    License URL
    https://www.dane.gov.co/index.php/servicios-al-ciudadano/tramites/transparencia-y-acceso-a-la-informacion-publica/terminos-y-condiciones
    Data URL
    https://microdatos.dane.gov.co
    Citation
    Departamento Administrativo Nacional de Estadística (DANE). Gran Encuesta Integrada de Hogares (GEIH) [dataset]. https://www.dane.gov.co. Access date: 2026.
    Global VIIRS Nighttime Lights
    Name
    Global VIIRS Nighttime Lights
    Note
    File location: growth/Cleaning_PEP_colombia_adm2.dta. A municipality-by-year panel merging annual mean night-light density (light_mean, nl_meanyear*) with municipal revenue and expenditure aggregates (the y_* and g_* families, in levels, per capita and in logs) and baseline characteristics (poverty, NBI, Gini, urban share, population). As with the GEIH file, this was assembled for the earlier PEP project, and it carries that project's treatment indicators (tpep, dtreatment, dtreat_post). The present package uses the night-light and municipal fiscal series only, in the local-activity test reported in the mechanisms section.
    Access policy
    Data is publicly available and included in the reproducibility package.
    License
    Creative Commons Attribution 4.0 International license (CC-BY 4.0)
    License URL
    https://creativecommons.org/licenses/by/4.0/deed.en
    Data URL
    https://eogdata.mines.edu/products/vnl/
    Citation
    Elvidge, C. D., Zhizhin, M., Ghosh, T., Hsu, F.-C., & Taneja, J. (2021). Annual Time Series of Global VIIRS Nighttime Lights. Earth Observation Group, Payne Institute for Public Policy, Colorado School of Mines. https://eogdata.mines.edu/products/vnl/ . Accessed 2026.
    Data statement

    Some data is restricted and has not been included in the reproducibility package. For more details, refer to the README file.

    Description

    Output
    Public Externalities Of Universal Health Care Access
    Type
    Working Paper
    Title
    Public Externalities Of Universal Health Care Access
    Authors
    Tatiana Hiller, Leonardo Peñaloza-Pacheco, Sandra V. Rozo
    Description
    Policy Research Working Papers (PRWP)
    Authors
    Author Affiliation Email
    Sandra V. Rozo World Bank sandrarozo@worldbank.org
    Tatiana Hiller University of California Davis Tatiana Hiller
    Leonardo Peñaloza-Pacheco Cornell University ljp96@cornell.edu
    Date of production

    2026-08-24

    Scope and coverage

    Geographic locations
    Location Code
    Colombia COL
    Keywords
    Migration Health Insurance Public Health Externalities Colombia Venezuela
    Topics
    ID Topic Parent topic ID Vocabulary Vocabulary URI
    F22 International Migration F2 Journal of Economic Literature (JEL)
    I13 Health Insurance, Public and Private I1 Journal of Economic Literature (JEL)
    I18 Government Policy • Regulation • Public Health I1 Journal of Economic Literature (JEL)
    H51 Government Expenditures and Health H5 Journal of Economic Literature (JEL)
    O15 Human Resources • Human Development • Income Distribution • Migration O1 Journal of Economic Literature (JEL)
    R23 Regional Migration • Regional Labor Markets • Population • Neighborhood Characteristics R2 Journal of Economic Literature (JEL)

    Disclaimer

    Disclaimer

    The materials in the reproducibility packages are distributed as they were prepared by the staff of the International Bank for Reconstruction and Development/The World Bank. The findings, interpretations, and conclusions expressed in this event do not necessarily reflect the views of the World Bank, the Executive Directors of the World Bank, or the governments they represent. The World Bank does not guarantee the accuracy of the materials included in the reproducibility package.

    Access and rights

    License
    Name URI
    MIT License https://opensource.org/license/mit
    World Bank IGO Rider https://github.com/worldbank/metadata-editor/blob/main/WB-IGO-RIDER.md

    Contacts

    Contacts
    Name Affiliation Email
    Sandra V. Rozo World Bank sandrarozo@worldbank.org
    Reproducibility WBG World Bank reproducibility@worldbank.org

    Information on metadata

    Producers
    Name Abbreviation Affiliation Role
    Reproducibility WBG DECDI World Bank - Development Impact Department Verification and preparation of metadata
    Date of Production

    2026-08-24

    Document version

    1

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