Access to care [9,10]. Even so, it hasbeen a extended, complicated course of action, along with the results are controversial [11,12]. In spite with the considerable increase in public overall health expenditure from 3 to six.six of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.3 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) drastically inferior to that supplied by the contributory 1 [16,17]. Around 17 of health expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting everyday operations (economic, personnel, and information management) and enrollment processes [19]. Furthermore, many research seem to indicate a reduce in realized access to solutions [20,21], and point to important barriers connected to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of solutions, which include geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that may be sensitive to the overall healthcare method, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, although per capita 2004 overall health expenditure were related (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Solutions Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, offered evidence points to failures within the condition sine qua non for the successful implementation of managed competitors, in line with its supporters [1]: the existence of an efficient regulatory program. These research [32-35] reveal deficiencies in regulation authorities in their capability to handle an excellent variety of institutions related to insufficient monetary resources, lack of handle mechanisms and excessive, and at times contradictory, regulation norms. Most research on the determinants of use of care in Colombia focus on private variables and initial speak to with services, and ignore contextual variables well being policy and traits of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is usually viewed as an independent variable, even though in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. Moreover, little research has evaluated access from the point of view on the social actors [26,37-39], regardless of the restricted capacity of quantitative models in explaining determinants of use of care, on account of methodological issues in such as contextual variables [40,41]. The objective of this article is usually to contribute for the improvement of our understanding in the aspects influencing access for the continuum of healthcare solutions within the Colombian managed competition model, in the viewpoint of social actors.Methods There were two Places of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one particular 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, when CB-5083 price inside the latter only a single subsidized insurance coverage organization, using the majority of your contributory insurance enrollees being affiliated in two insurance coverage businesses. In each locations the majority of the population reside in poverty [42]. Within the urban region, the coverage in the subsidized regime is slightly significantly less than inside the rural a.