Access to care [9,10]. Nonetheless, it hasbeen a extended, difficult approach, plus the outcomes are controversial [11,12]. In spite on the considerable enhance in public overall health expenditure from 3 to 6.six of GDP, more than the 1993 to 2007 period [13], around 15.three to 19.three of the 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 supplied by the contributory a single [16,17]. Approximately 17 of well being expenditure is devoted to administrative fees [18], of which greater than 50 is spent on supporting every day operations (monetary, personnel, and data management) and enrollment processes [19]. Moreover, many studies look to indicate a reduce in realized access to solutions [20,21], and point to important barriers associated to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of solutions, which include geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive to the all round healthcare technique, was 130/100.000 in Colombia, compared to 30/ one hundred.000 in Costa Rica, while per capita 2004 wellness expenditure were equivalent (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 Well being Services Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available 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 effective regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to control an awesome number of institutions connected to insufficient economic resources, lack of manage mechanisms and excessive, and occasionally contradictory, regulation norms. Most research with the determinants of use of care in Colombia focus on private variables and initial speak to with solutions, and ignore contextual variables well being policy and traits of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is generally viewed as an independent variable, despite the fact that in managed competitors models, insurers straight influence the provider networks and conditions of access to healthcare [36]. Moreover, little investigation has evaluated access in the point of view with the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological troubles in including contextual variables [40,41]. The objective of this short PP58 site article should be to contribute towards the improvement of our understanding from the things influencing access to the continuum of healthcare solutions inside the Colombian managed competition model, in the viewpoint of social actors.Approaches There were two Regions of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and a single 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, although inside the latter only 1 subsidized insurance organization, with all the majority on the contributory insurance coverage enrollees becoming affiliated in two insurance firms. In each places most of the population reside in poverty [42]. Inside the urban area, the coverage on the subsidized regime is slightly much less than in the rural a.