Access to care [9,10]. Nonetheless, it hasbeen a lengthy, complex approach, plus the outcomes are controversial [11,12]. In spite in the considerable enhance in public wellness expenditure from 3 to six.six of GDP, over the 1993 to 2007 period [13], about 15.three to 19.3 of your population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a range of services (POS-S) significantly inferior to that offered by the contributory one particular [16,17]. About 17 of wellness expenditure is devoted to administrative charges [18], of which greater than 50 is spent on supporting daily operations (financial, personnel, and info management) and enrollment processes [19]. Furthermore, many research appear to indicate a reduce in realized access to services [20,21], and point to significant barriers associated to qualities 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, like geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive towards the general healthcare system, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, PK14105 site though per capita 2004 overall health expenditure had been related (USD 549 and USD 598, respectively) but a GNP per capita lower in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Services Investigation 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, offered evidence points to failures inside the condition sine qua non for the effective implementation of managed competitors, in accordance with its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to manage an excellent quantity of institutions connected to insufficient economic sources, lack of control mechanisms and excessive, and at times contradictory, regulation norms. Most studies in the determinants of use of care in Colombia focus on private variables and initial contact with services, and ignore contextual variables overall health policy and characteristics of healthcare services. Insurance coverage, measured only by enrolment rate, is typically viewed as an independent variable, even though in managed competitors models, insurers directly influence the provider networks and situations of access to healthcare [36]. Moreover, little 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, on account of methodological difficulties in which includes contextual variables [40,41]. The objective of this article is to contribute towards the improvement of our understanding with the things influencing access towards the continuum of healthcare solutions within the Colombian managed competitors model, from the point of view of social actors.Techniques There had been two Locations of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and 1 rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Within the former, a wide array of insurers are present, when inside the latter only one particular subsidized insurance coverage business, with all the majority with the contributory insurance coverage enrollees getting affiliated in two insurance businesses. In each regions the majority of the population reside in poverty [42]. In the urban area, the coverage of your subsidized regime is slightly much less than within the rural a.