Access to care [9,10]. On the other hand, it hasbeen a long, difficult approach, along with the results are controversial [11,12]. In spite of your substantial increase in public well being expenditure from 3 to 6.six of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.3 on the N-Acetylneuraminic acid population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of services (POS-S) tremendously inferior to that provided by the contributory one [16,17]. Around 17 of wellness expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting daily operations (financial, personnel, and information management) and enrollment processes [19]. Furthermore, quite a few research look to indicate a reduce in realized access to solutions [20,21], and point to considerable barriers connected to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance 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 rate, an indicator that may be sensitive towards the overall healthcare technique, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, while per capita 2004 health expenditure have been equivalent (USD 549 and USD 598, respectively) but a GNP per capita lower within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Services Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, out there evidence points to failures in the condition sine qua non for the thriving implementation of managed competition, based on its supporters [1]: the existence of an efficient regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their capacity to manage an awesome variety of institutions related to insufficient monetary sources, lack of handle mechanisms and excessive, and sometimes contradictory, regulation norms. Most research in the determinants of use of care in Colombia focus on personal variables and initial make contact with with solutions, and ignore contextual variables overall health policy and traits of healthcare services. Insurance coverage, measured only by enrolment rate, is usually viewed as an independent variable, though in managed competition models, insurers directly influence the provider networks and conditions of access to healthcare [36]. Moreover, tiny investigation has evaluated access from the point of view in the social actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, resulting from methodological difficulties in like contextual variables [40,41]. The objective of this short article would be to contribute to the improvement of our understanding with the elements influencing access to the continuum of healthcare solutions inside the Colombian managed competition model, from the perspective of social actors.Solutions There had been two Regions of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and 1 rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Within the former, a wide array of insurers are present, while in the latter only a single subsidized insurance organization, using the majority on the contributory insurance coverage enrollees being affiliated in two insurance providers. In each places the majority of the population live in poverty [42]. Within the urban location, the coverage with the subsidized regime is slightly significantly less than in the rural a.