Access to care [9,10]. Nonetheless, it hasbeen a lengthy, complicated method, and the final results are controversial [11,12]. In spite of your substantial raise in public health expenditure from 3 to 6.6 of GDP, over the 1993 to 2007 period [13], around 15.3 to 19.3 in 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 supplied by the contributory a single [16,17]. Approximately 17 of DDP-38003 (trihydrochloride) web overall health expenditure is devoted to administrative fees [18], of which greater than 50 is spent on supporting daily operations (financial, personnel, and facts management) and enrollment processes [19]. Additionally, many studies seem to indicate a decrease in realized access to services [20,21], and point to significant barriers connected to characteristics 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, characteristics of services, including geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is sensitive towards the overall healthcare program, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, while per capita 2004 well being expenditure were similar (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 productive implementation of managed competitors, based on its supporters [1]: the existence of an effective regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their ability to manage a fantastic variety of institutions associated to insufficient economic sources, lack of handle mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies from the determinants of use of care in Colombia focus on private variables and initial speak to with services, and ignore contextual variables health policy and traits of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is normally viewed as an independent variable, although in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. Furthermore, small analysis 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, as a result of methodological difficulties in such as contextual variables [40,41]. The objective of this article is usually to contribute towards the improvement of our understanding with the aspects influencing access for the continuum of healthcare solutions within the Colombian managed competition model, in the viewpoint of social actors.Strategies There have been two Regions of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and a single rural (La Cumbre, Department 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 inside the latter only one subsidized insurance company, using the majority from the contributory insurance enrollees getting affiliated in two insurance coverage organizations. In both places the majority of the population live in poverty [42]. Within the urban area, the coverage of the subsidized regime is slightly less than in the rural a.