Abstract P454: Health Insurance Increases Access to Hypertension Treatment Among Venezuelan Migrants and Refugees: A Population-Based Survey in Peru

Abstract

Introduction: Over 6 million migrants and refugees have left Venezuela because of an ongoing political instability and socioeconomic crisis. This unprecedented migration has led to an increase of over 1 million Venezuelan migrants and refugees in Peru. Migrants are considered a vulnerable population and are often faced with discrimination, financial distress, and restricted access to health services. According to the literature, chronic diseases, such as hypertension, are the leading cause of preventable morbidity and premature death. In Peru, according to a 2018 survey, only 10.8% of Venezuelan migrants receive regular treatment for chronic diseases. Hypothesis: We assessed the hypothesis that having health insurance is associated with access to hypertension treatment. Methods: Cross-sectional study based on a secondary analysis from the 2022 survey of Venezuelan Population Living in Peru (ENPOVE 2022). The survey included 12,487 participants. Our population included Venezuelan migrants and refugees over 18 years old with self-reported hypertension. The outcome variable was to receive regular treatment, while the independent variable was having health insurance. Complex samplings characteristics and sampling weights of ENPOVE 2022, as well as the subpop command were used. Crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs) were obtained using Poisson log generalized linear regression models. Results: A total of 419 Venezuelan adults with self-reported hypertension were included in our study, of whom only 26.5% (95% CI 20.1-33.0) received regular treatment. Mean age was 50.3 ±12.9 (standard deviation) years old. Moreover, 30% perceived discrimination (95% CI 24.5-36.0), 39.1% (95% CI 32.4-46.2) were undocumented and 69% (95% CI 62.1- 75.1) did not have health insurance. In the multivariate analysis, after controlling by sex, age, socio-economic status, perceived discrimination, immigration status and disability, having health insurance was associated with receiving regular treatment (aPR 2.33; 95% CI 1.47-3.70). Neither perceived discrimination (aPR 0.62; 95% CI 0.37-1.05) nor disability (aPR 1.46; 95% CI 0.08-2.55) were associated with receiving regular treatment. Conclusions: In conclusion, less than 1/3 of migrants and refugees with hypertension have access to regular treatment. Having health insurance was associated with receiving regular treatment for hypertension. There is a need to improve health insurance coverage among migrants and refugees regardless of the immigration status.