Access to care [9,10]. Nonetheless, it hasbeen a extended, complex course of action, and the results are controversial [11,12]. In spite of your substantial enhance in public wellness expenditure from 3 to six.six of GDP, over the 1993 to 2007 period [13], about 15.three to 19.3 from the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of solutions (POS-S) drastically inferior to that provided by the contributory 1 [16,17]. Around 17 of health expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting everyday operations (economic, personnel, and details management) and enrollment processes [19]. Additionally, several 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 enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, qualities of services, including geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive for the general healthcare program, was 130/100.000 in Colombia, compared to 30/ 100.000 in Costa Rica, even though per capita 2004 overall health expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita lower in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Investigation 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable proof points to failures inside the condition sine qua non for the successful implementation of managed competition, as outlined by its supporters [1]: the existence of an effective regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their capacity to control a great quantity of institutions related to insufficient financial resources, lack of manage mechanisms and excessive, and occasionally contradictory, regulation norms. Most studies of your determinants of use of care in Colombia focus on individual variables and initial make contact with with solutions, and ignore contextual variables well being policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is usually viewed as an independent variable, although in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Additionally, tiny study has evaluated access in the point of view with the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, because of 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 of your variables influencing access for the continuum of healthcare services within the Colombian managed competitors model, from the point of view of social actors.Approaches There had been two Locations of Study: 1 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. In the former, a wide array of insurers are present, whilst inside the latter only 1 subsidized insurance organization, using the majority in the contributory insurance enrollees getting affiliated in two insurance providers. In each AMG9810 biological activity places most of the population reside in poverty [42]. Within the urban region, the coverage on the subsidized regime is slightly significantly less than within the rural a.