Access to care [9,10]. However, it hasbeen a lengthy, difficult course of action, and the benefits are controversial [11,12]. In spite of the important improve in public overall health expenditure from three to 6.6 of GDP, more than the 1993 to 2007 period [13], around 15.3 to 19.three from the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of services (POS-S) considerably inferior to that offered by the contributory 1 [16,17]. Around 17 of wellness expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting every day operations (economic, personnel, and information management) and enrollment processes [19]. Moreover, several studies look to indicate a decrease in realized access to services [20,21], and point to considerable barriers related to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, qualities of services, such as geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is definitely sensitive to the all round healthcare method, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, although per capita 2004 overall health expenditure were 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 Services Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available proof points to failures in the situation sine qua non for the effective implementation of managed competition, based on its supporters [1]: the existence of an effective regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their potential to manage a fantastic number of institutions associated to insufficient monetary resources, lack of manage mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies in the determinants of use of care in Colombia concentrate on private variables and initial get in touch with with solutions, and ignore contextual variables health policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment rate, is often viewed as an independent variable, despite the fact that in managed competition models, insurers directly influence the provider purchase CTX-0294885 (hydrochloride) networks and conditions of access to healthcare [36]. Furthermore, small investigation has evaluated access from the point of view of your social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, due to methodological difficulties in such as contextual variables [40,41]. The objective of this short article should be to contribute to the improvement of our understanding from the elements influencing access for the continuum of healthcare services within the Colombian managed competitors model, from the perspective of social actors.Solutions There had been two Places of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and a single 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, whilst within the latter only one subsidized insurance business, with all the majority on the contributory insurance coverage enrollees becoming affiliated in two insurance coverage businesses. In both regions most of the population reside in poverty [42]. Inside the urban region, the coverage on the subsidized regime is slightly significantly less than in the rural a.