Access to care [9,10]. Nonetheless, it hasbeen a long, difficult process, along with the final results are controversial [11,12]. In spite with the important raise in public health expenditure from three to six.six of GDP, over the 1993 to 2007 period [13], about 15.three to 19.three from the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of solutions (POS-S) drastically inferior to that provided by the contributory 1 [16,17]. Roughly 17 of well being expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting daily operations (financial, personnel, and facts management) and enrollment processes [19]. Furthermore, several studies appear to indicate a reduce in realized access to services [20,21], and point to important barriers related to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], income [22,25,26,28], education [22-27,29] and, characteristics of solutions, like geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is definitely sensitive to the general healthcare system, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, though per capita 2004 overall health expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita reduce in the order ML364 former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Solutions Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available proof points to failures in the condition sine qua non for the thriving implementation of managed competitors, in line with its supporters [1]: the existence of an efficient regulatory method. These research [32-35] reveal deficiencies in regulation authorities in their potential to handle an awesome quantity of institutions related to insufficient economic sources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most research of the determinants of use of care in Colombia focus on individual variables and initial make contact with with solutions, and ignore contextual variables wellness policy and qualities of healthcare services. Insurance coverage, measured only by enrolment price, is often viewed as an independent variable, even though in managed competition models, insurers straight influence the provider networks and situations of access to healthcare [36]. Moreover, small research has evaluated access from the point of view from the social actors [26,37-39], in spite 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 short article should be to contribute for the improvement of our understanding on the components influencing access to the continuum of healthcare services inside the Colombian managed competitors model, from the point of view of social actors.Methods There have been two Areas of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Inside the former, a wide array of insurers are present, even though inside the latter only a single subsidized insurance corporation, with the majority of the contributory insurance enrollees being affiliated in two insurance coverage providers. In both areas most of the population reside in poverty [42]. Within the urban area, the coverage from the subsidized regime is slightly significantly less than inside the rural a.