Access to care [9,10]. On the other hand, it hasbeen a long, complicated approach, and also the final results are controversial [11,12]. In spite in the considerable increase in public wellness expenditure from three to six.six of GDP, more than the 1993 to 2007 period [13], around 15.three to 19.3 of the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a range of solutions (POS-S) considerably inferior to that provided by the contributory one [16,17]. Approximately 17 of wellness expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting daily operations (economic, personnel, and info management) and enrollment processes [19]. Moreover, numerous studies look to indicate a decrease in realized access to services [20,21], and point to important barriers related 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, traits of solutions, for example geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive for the general healthcare program, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, though per capita 2004 overall health expenditure were related (USD 549 and USD 598, respectively) but a GNP per capita decrease in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Solutions Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available evidence points to failures within the condition sine qua non for the productive implementation of managed competition, in accordance with its supporters [1]: the existence of an efficient regulatory method. These research [32-35] reveal deficiencies in regulation authorities in their ability to handle an excellent variety of institutions associated to insufficient financial resources, lack of manage mechanisms and excessive, and occasionally contradictory, regulation norms. Most research of your determinants of use of care in Colombia concentrate on personal variables and initial get in touch with with solutions, 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, though in managed competitors models, insurers straight influence the provider networks and conditions of access to healthcare [36]. In addition, little research has evaluated access from the point of view of your social actors [26,37-39], in spite of the limited capacity of quantitative models in explaining determinants of use of care, as a result of methodological troubles in like contextual variables [40,41]. The objective of this article is to contribute to the improvement of our understanding of your Procyanidin B2 aspects influencing access for the continuum of healthcare solutions within the Colombian managed competition model, in the viewpoint of social actors.Techniques There have been two Locations of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one 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, though within the latter only a single subsidized insurance coverage organization, with all the majority from the contributory insurance coverage enrollees being affiliated in two insurance companies. In both regions most of the population live in poverty [42]. Inside the urban region, the coverage on the subsidized regime is slightly significantly less than within the rural a.