Access to care [9,10]. Even so, it hasbeen a lengthy, complex procedure, and also the outcomes are controversial [11,12]. In spite of your significant increase in public well being expenditure from three to six.6 of GDP, more than the 1993 to 2007 period [13], around 15.3 to 19.three in the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) tremendously inferior to that offered by the contributory one particular [16,17]. Roughly 17 of wellness expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting day-to-day operations (financial, personnel, and information management) and enrollment processes [19]. In addition, a number of research seem to indicate a reduce in realized access to solutions [20,21], and point to substantial barriers associated to traits 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, characteristics of solutions, such as geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive towards the all round healthcare system, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, even though per capita 2004 well being expenditure have been similar (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, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, out there proof points to failures inside the condition sine qua non for the profitable implementation of managed competitors, based on its supporters [1]: the [DTrp6]-LH-RH site existence of an effective regulatory method. These research [32-35] reveal deficiencies in regulation authorities in their potential to handle an incredible number of institutions associated to insufficient monetary resources, lack of handle mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies with the determinants of use of care in Colombia focus on personal variables and initial contact with solutions, and ignore contextual variables overall health policy and traits of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is usually viewed as an independent variable, while in managed competition models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. Moreover, little analysis has evaluated access in the point of view with the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, because of methodological troubles in including contextual variables [40,41]. The objective of this article would be to contribute towards the improvement of our understanding with the factors influencing access to the continuum of healthcare services within the Colombian managed competitors model, in the perspective of social actors.Strategies There have been two Areas of Study: 1 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. In the former, a wide array of insurers are present, though inside the latter only one particular subsidized insurance corporation, together with the majority of your contributory insurance enrollees getting affiliated in two insurance coverage companies. In each regions the majority of the population live in poverty [42]. Inside the urban region, the coverage in the subsidized regime is slightly less than inside the rural a.