Access to care [9,10]. Having said that, it hasbeen a lengthy, difficult course of action, along with the outcomes are controversial [11,12]. In spite with the considerable boost in public wellness expenditure from three to six.six of GDP, over the 1993 to 2007 period [13], around 15.three to 19.three from the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of solutions (POS-S) significantly inferior to that supplied by the contributory one particular [16,17]. Around 17 of wellness expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting day-to-day operations (financial, personnel, and facts management) and enrollment processes [19]. Furthermore, several studies seem to indicate a reduce in realized access to solutions [20,21], and point to significant barriers related to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance MedChemExpress CTX-0294885 (hydrochloride) coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, qualities of services, which include geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality rate, an indicator which is sensitive to the all round healthcare technique, was 130/100.000 in Colombia, when compared with 30/ one hundred.000 in Costa Rica, though per capita 2004 wellness expenditure had been equivalent (USD 549 and USD 598, respectively) but a GNP per capita lower inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Solutions Investigation 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available proof points to failures in the condition sine qua non for the thriving implementation of managed competitors, according to its supporters [1]: the existence of an efficient regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their ability to handle an awesome quantity of institutions associated to insufficient economic resources, lack of manage mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies with the determinants of use of care in Colombia focus on individual variables and initial contact with solutions, and ignore contextual variables overall health policy and qualities of healthcare services. Insurance coverage, measured only by enrolment rate, is normally viewed as an independent variable, even though in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Moreover, tiny study has evaluated access from the point of view on the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, because of methodological issues in like contextual variables [40,41]. The objective of this article is usually to contribute towards the improvement of our understanding in the things influencing access to the continuum of healthcare services in the Colombian managed competition model, in the point of view of social actors.Solutions There had been two Places of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. In the former, a wide array of insurers are present, though within the latter only one particular subsidized insurance coverage business, together with the majority of the contributory insurance enrollees getting affiliated in two insurance businesses. In each regions most of the population reside in poverty [42]. Inside the urban area, the coverage on the subsidized regime is slightly much less than in the rural a.