Access to care [9,10]. Nonetheless, it hasbeen a extended, complex procedure, and the benefits are controversial [11,12]. In spite from the significant raise in public health expenditure from 3 to 6.6 of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three with the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a variety of services (POS-S) drastically inferior to that offered by the contributory 1 [16,17]. Approximately 17 of health expenditure is devoted to administrative charges [18], of which more than 50 is spent on supporting every day operations (monetary, personnel, and information management) and enrollment processes [19]. In addition, many research look to indicate a lower in realized access to services [20,21], and point to considerable barriers associated to qualities 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, traits of solutions, such as geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is definitely sensitive towards the overall healthcare method, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, although per capita 2004 health expenditure have been similar (USD 549 and USD 598, respectively) but a GNP per capita reduced inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Services Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, MSX-122 site readily available proof points to failures inside the situation sine qua non for the effective implementation of managed competition, in line with its supporters [1]: the existence of an effective regulatory method. These research [32-35] reveal deficiencies in regulation authorities in their capacity to control a fantastic number of institutions connected to insufficient monetary sources, lack of handle mechanisms and excessive, and at times contradictory, regulation norms. Most research from the determinants of use of care in Colombia concentrate on personal variables and initial make contact with with services, and ignore contextual variables well being policy and characteristics of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is usually viewed as an independent variable, while in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare [36]. In addition, small investigation has evaluated access in the point of view with the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, resulting from methodological troubles in such as contextual variables [40,41]. The objective of this short article should be to contribute to the improvement of our understanding of your aspects influencing access towards the continuum of healthcare solutions within the Colombian managed competitors model, from the perspective of social actors.Strategies There were two Locations of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and a single 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 in the latter only 1 subsidized insurance enterprise, using the majority on the contributory insurance coverage enrollees becoming affiliated in two insurance coverage providers. In each locations the majority of the population live in poverty [42]. In the urban location, the coverage of your subsidized regime is slightly less than within the rural a.