Access to care [9,10]. Nonetheless, it hasbeen a extended, complex approach, as well as the benefits are controversial [11,12]. In spite in the significant increase in public wellness expenditure from 3 to six.six of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.three on the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of solutions (POS-S) greatly inferior to that provided by the contributory one particular [16,17]. Approximately 17 of overall health expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting each day operations (monetary, personnel, and data management) and enrollment processes [19]. Moreover, quite a few research seem to indicate a lower in realized access to services [20,21], and point to significant 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, characteristics of services, including geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator that is sensitive to the all round healthcare system, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, although per capita 2004 overall health expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita decrease inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn AZD5153 (6-Hydroxy-2-naphthoic acid) addition, offered proof points to failures inside the situation sine qua non for the prosperous implementation of managed competition, as outlined by its supporters [1]: the existence of an effective regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their potential to control a great variety of institutions related to insufficient financial sources, lack of handle mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies of your determinants of use of care in Colombia concentrate on individual variables and initial speak to with solutions, and ignore contextual variables overall health policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment price, is normally viewed as an independent variable, while in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Also, small analysis has evaluated access from the point of view with the 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 issues in which includes contextual variables [40,41]. The objective of this short article will be to contribute to the improvement of our understanding on the things influencing access towards the continuum of healthcare solutions within the Colombian managed competition model, from the perspective of social actors.Techniques There were two Locations of Study: one particular 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 inside the latter only one subsidized insurance business, with the majority on the contributory insurance coverage enrollees getting affiliated in two insurance companies. In both places most of the population live in poverty [42]. Within the urban region, the coverage of the subsidized regime is slightly less than in the rural a.