Access to care [9,10]. Nonetheless, it hasbeen a extended, difficult approach, along with the final results are controversial [11,12]. In spite of your important improve in public overall health expenditure from 3 to 6.6 of GDP, over the 1993 to 2007 period [13], about 15.three to 19.3 from the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) greatly inferior to that supplied by the contributory one particular [16,17]. Approximately 17 of well being expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting daily operations (economic, personnel, and information and facts management) and enrollment processes [19]. Additionally, several research appear to indicate a lower in realized access to services [20,21], and point to important barriers associated to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, qualities of services, which include geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is sensitive for the overall healthcare system, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, although per capita 2004 health expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita reduce in 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, readily available proof points to failures in the condition sine qua non for the thriving implementation of managed competitors, based on its supporters [1]: the existence of an effective regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their capability to manage a terrific variety of institutions connected to insufficient financial resources, lack of manage mechanisms and excessive, and from time to time contradictory, regulation norms. Most research with the determinants of use of care in Colombia concentrate on individual variables and initial contact with services, and ignore contextual variables overall health policy and qualities of healthcare services. Insurance coverage, measured only by enrolment rate, is frequently viewed as an independent variable, even though in managed competition models, insurers directly influence the provider networks and situations of access to healthcare [36]. In addition, small investigation has evaluated access in the point of view from the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, due to methodological issues in like contextual variables [40,41]. The objective of this short article is always to contribute to the improvement of our understanding of the variables influencing access to the continuum of healthcare services within the Colombian managed competitors model, from the perspective of social actors.Methods There have been two Locations of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and a single rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Inside the former, a wide array of insurers are present, whilst inside the latter only one subsidized insurance coverage company, using the majority of the contributory insurance coverage enrollees becoming affiliated in two insurance coverage AMG9810 web businesses. In each places the majority of the population reside in poverty [42]. In the urban region, the coverage with the subsidized regime is slightly much less than inside the rural a.