Access to care [9,10]. Nonetheless, it hasbeen a long, complicated process, and also the outcomes are controversial [11,12]. In spite with the significant enhance in public overall health expenditure from three to six.six of GDP, over the 1993 to 2007 period [13], about 15.three to 19.three of the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of solutions (POS-S) significantly inferior to that supplied by the contributory one particular [16,17]. About 17 of wellness expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting everyday operations (monetary, personnel, and data management) and enrollment processes [19]. Furthermore, several studies look to indicate a decrease in realized access to services [20,21], and point to substantial barriers associated to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, characteristics of solutions, for example geographic accessibility and high quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is definitely sensitive to the general healthcare program, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, even though per capita 2004 well being expenditure were equivalent (USD 549 and USD 598, respectively) but a GNP per capita decrease inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Services Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available evidence points to failures within the condition sine qua non for the prosperous implementation of managed competitors, according to its supporters [1]: the existence of an efficient regulatory technique. These research [32-35] reveal deficiencies in regulation authorities in their potential to handle an excellent quantity of institutions related to insufficient economic sources, lack of manage mechanisms and excessive, and occasionally contradictory, regulation norms. Most research of your determinants of use of care in Colombia focus on private variables and initial contact with services, and ignore contextual variables overall health policy and traits of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is normally viewed as an independent variable, even though in managed competition models, insurers straight influence the provider networks and conditions of access to healthcare [36]. Additionally, small analysis has evaluated access in the point of view with the social CCT251545 manufacturer actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, as a result of methodological difficulties in like contextual variables [40,41]. The objective of this short article will be to contribute to the improvement of our understanding on the components influencing access for the continuum of healthcare solutions within the Colombian managed competitors model, from the perspective of social actors.Solutions There were two Areas of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. In the former, a wide array of insurers are present, even though in the latter only a single subsidized insurance coverage corporation, with the majority with the contributory insurance enrollees getting affiliated in two insurance companies. In both locations the majority of the population reside in poverty [42]. In the urban area, the coverage from the subsidized regime is slightly significantly less than within the rural a.