Access to care [9,10]. Even so, it hasbeen a long, complicated procedure, and the results are controversial [11,12]. In spite of the considerable increase in public wellness expenditure from three to 6.6 of GDP, over the 1993 to 2007 period [13], around 15.3 to 19.3 on the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a range of services (POS-S) greatly inferior to that supplied by the contributory a single [16,17]. About 17 of well being expenditure is devoted to administrative charges [18], of which more than 50 is spent on supporting each day operations (financial, personnel, and data management) and enrollment processes [19]. Moreover, a number of studies appear to indicate a reduce in realized access to solutions [20,21], and point to considerable barriers connected to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], income [22,25,26,28], education [22-27,29] and, characteristics of services, for instance geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality price, an indicator which is sensitive to the general healthcare technique, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, while per capita 2004 health expenditure have been equivalent (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Solutions Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, out there evidence points to failures in the condition sine qua non for the profitable implementation of managed competitors, based on its supporters [1]: the existence of an efficient regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to manage a fantastic variety of institutions associated to insufficient monetary sources, lack of handle mechanisms and excessive, and often contradictory, regulation norms. Most research from the determinants of use of care in Colombia concentrate on individual variables and initial contact with services, and ignore contextual variables wellness policy and characteristics of healthcare solutions. Insurance coverage, measured only by enrolment rate, is generally viewed as an independent variable, though in managed competitors models, insurers directly influence the provider networks and situations of access to healthcare [36]. Moreover, little analysis has evaluated access from the point of view from the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, as a result of methodological issues in including contextual variables [40,41]. The objective of this article would be to contribute towards the improvement of our understanding in the things influencing access to the continuum of healthcare solutions inside the Colombian managed competition model, from the perspective of social actors.Approaches There have been two Regions 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 order F16 inhabitants [43] respectively. Within the former, a wide array of insurers are present, even though in the latter only 1 subsidized insurance corporation, together with the majority of your contributory insurance coverage enrollees being affiliated in two insurance organizations. In both places the majority of the population live in poverty [42]. Inside the urban location, the coverage of the subsidized regime is slightly less than within the rural a.