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Access to care [9,10]. On the other hand, it hasbeen a extended, complicated approach, along with the benefits are controversial [11,12]. In spite with the important enhance in public health expenditure from three to 6.6 of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three with the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of solutions (POS-S) considerably inferior to that supplied by the contributory a single [16,17]. Approximately 17 of well being expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting everyday operations (financial, personnel, and data management) and enrollment processes [19]. Additionally, several research look to indicate a lower in realized access to services [20,21], and point to important barriers associated to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of solutions, which include geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality rate, an indicator which is sensitive towards the overall ATP-polyamine-biotin chemical information healthcare program, was 130/100.000 in Colombia, compared to 30/ one hundred.000 in Costa Rica, while per capita 2004 well being expenditure had been related (USD 549 and USD 598, respectively) but a GNP per capita reduced in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, readily available proof points to failures within the situation sine qua non for the prosperous implementation of managed competition, according to its supporters [1]: the existence of an effective regulatory technique. These studies [32-35] reveal deficiencies in regulation authorities in their ability to manage an excellent number of institutions related to insufficient monetary resources, lack of control mechanisms and excessive, and occasionally contradictory, regulation norms. Most research from the determinants of use of care in Colombia concentrate on private variables and initial make contact with with services, and ignore contextual variables wellness policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is normally viewed as an independent variable, while in managed competition models, insurers directly influence the provider networks and conditions of access to healthcare [36]. In addition, small study has evaluated access in the point of view from the social actors [26,37-39], regardless of the restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological troubles in like contextual variables [40,41]. The objective of this article is usually to contribute for the improvement of our understanding of your factors influencing access for the continuum of healthcare solutions inside the Colombian managed competition model, in the point of view of social actors.Solutions There had been two Areas of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and 1 rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Within the former, a wide array of insurers are present, whilst in the latter only one subsidized insurance coverage company, with the majority in the contributory insurance enrollees becoming affiliated in two insurance corporations. In both regions the majority of the population live in poverty [42]. In the urban location, the coverage from the subsidized regime is slightly much less than within the rural a.