Access to care [9,10]. However, it hasbeen a long, difficult process, plus the outcomes are controversial [11,12]. In spite in the substantial improve in public wellness expenditure from 3 to six.six of GDP, over the 1993 to 2007 period [13], around 15.three to 19.3 from the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) tremendously inferior to that provided by the contributory one particular [16,17]. Roughly 17 of overall health expenditure is devoted to administrative charges [18], of which more than 50 is spent on supporting daily operations (monetary, personnel, and information management) and enrollment processes [19]. Furthermore, various studies appear to indicate a decrease in realized access to solutions [20,21], and point to considerable 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, qualities of solutions, like geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is definitely sensitive for the general healthcare system, was 130/100.000 in Colombia, when compared with 30/ one hundred.000 in Costa Rica, although per capita 2004 overall health expenditure have been similar (USD 549 and USD 598, respectively) but a GNP per capita decrease within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable evidence points to failures in the condition sine qua non for the effective implementation of managed competitors, in line with its supporters [1]: the existence of an efficient regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their capability to control an awesome quantity of institutions associated to insufficient economic sources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most research in the determinants of use of care in Colombia focus on personal variables and initial contact with solutions, and MedChemExpress CC122 ignore contextual variables overall health policy and characteristics of healthcare solutions. Insurance coverage, measured only by enrolment price, is often viewed as an independent variable, though in managed competition models, insurers straight influence the provider networks and situations of access to healthcare [36]. Moreover, tiny 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, due to methodological difficulties in which includes contextual variables [40,41]. The objective of this short article should be to contribute to the improvement of our understanding from the variables influencing access towards the continuum of healthcare services in the Colombian managed competitors model, in the perspective of social actors.Strategies There were two Regions of Study: a single 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. Inside the former, a wide array of insurers are present, even though within the latter only one particular subsidized insurance firm, with all the majority of your contributory insurance coverage enrollees getting affiliated in two insurance coverage companies. In each locations most of the population reside in poverty [42]. Within the urban area, the coverage of your subsidized regime is slightly significantly less than inside the rural a.