Access to care [9,10]. Nevertheless, it hasbeen a lengthy, complicated method, and the outcomes are controversial [11,12]. In spite with the substantial raise in public health expenditure from three to 6.six of GDP, over the 1993 to 2007 period [13], around 15.3 to 19.3 from the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) significantly inferior to that provided by the contributory a single [16,17]. About 17 of overall health expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting daily operations (financial, personnel, and data management) and enrollment processes [19]. In addition, many studies seem to indicate a decrease in realized access to services [20,21], and point to significant 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, like geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that may be sensitive towards the all round healthcare program, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, though per capita 2004 well being expenditure were related (USD 549 and USD 598, respectively) but a GNP per capita reduce within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Investigation 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, offered proof points to failures within the situation sine qua non for the effective implementation of managed competitors, according to its supporters [1]: the existence of an effective regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their potential to control an excellent variety of institutions associated to insufficient monetary sources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies from the determinants of use of care in Colombia focus on individual variables and initial speak to with services, and ignore MedChemExpress HPOB contextual variables overall health policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment price, is normally viewed as an independent variable, although in managed competitors models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Additionally, small study has evaluated access from the point of view of the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, because of methodological troubles in such as contextual variables [40,41]. The objective of this article is always to contribute to the improvement of our understanding with the elements influencing access for the continuum of healthcare solutions within the Colombian managed competition model, in the viewpoint of social actors.Techniques There had been two Regions 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. Inside the former, a wide array of insurers are present, although inside the latter only one subsidized insurance company, using the majority of the contributory insurance enrollees getting affiliated in two insurance organizations. In both places the majority of the population live in poverty [42]. Within the urban location, the coverage of the subsidized regime is slightly significantly less than in the rural a.