Access to care [9,10]. Nevertheless, it hasbeen a long, complex method, along with the outcomes are controversial [11,12]. In spite of your significant increase in public overall health expenditure from 3 to 6.six of GDP, over the 1993 to 2007 period [13], about 15.three to 19.three in the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of services (POS-S) drastically inferior to that offered by the contributory one [16,17]. Around 17 of overall health expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting every day operations (economic, personnel, and details management) and enrollment processes [19]. In addition, numerous research appear to indicate a lower in realized access to solutions [20,21], and point to important barriers connected to qualities 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 solutions, which include geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality price, an buy BAY-1143572 indicator which is sensitive for the overall healthcare program, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, whilst 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 Wellness Services Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, offered evidence points to failures inside the situation sine qua non for the profitable implementation of managed competition, as outlined by its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to manage an awesome variety of institutions associated to insufficient economic resources, lack of handle mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies in the determinants of use of care in Colombia focus on personal variables and initial get in touch with with solutions, and ignore contextual variables well being policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment price, is generally viewed as an independent variable, despite the fact that in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare [36]. Additionally, tiny research has evaluated access from the point of view from the social actors [26,37-39], regardless of the restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological difficulties in including contextual variables [40,41]. The objective of this article should be to contribute towards the improvement of our understanding of the aspects influencing access for the continuum of healthcare services within the Colombian managed competitors model, from the perspective of social actors.Solutions There have been two Regions 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, whilst inside the latter only a single subsidized insurance coverage enterprise, together with the majority with the contributory insurance enrollees getting affiliated in two insurance companies. In both regions most of the population live in poverty [42]. Inside the urban area, the coverage in the subsidized regime is slightly less than inside the rural a.