Access to care [9,10]. Even so, it hasbeen a long, difficult approach, as well as the benefits are controversial [11,12]. In spite with the considerable raise in public health expenditure from three to six.6 of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.3 with the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) tremendously inferior to that offered by the contributory a single [16,17]. Around 17 of wellness expenditure is devoted to administrative charges [18], of which greater than 50 is spent on supporting every day operations (economic, personnel, and info management) and enrollment processes [19]. Moreover, a number of studies appear to indicate a lower 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 coverage enrolment [22-28], income [22,25,26,28], education [22-27,29] and, traits of solutions, such as geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that’s sensitive for the all round healthcare technique, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, when per MedChemExpress GLPG0187 capita 2004 wellness expenditure have been comparable (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 Overall health Solutions Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, offered evidence points to failures in the situation sine qua non for the thriving 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 potential to control an incredible quantity of institutions related to insufficient monetary resources, lack of control mechanisms and excessive, and often contradictory, regulation norms. Most research with the determinants of use of care in Colombia focus on personal variables and initial speak to with services, and ignore contextual variables overall health policy and characteristics of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is typically viewed as an independent variable, even though in managed competition models, insurers straight influence the provider networks and situations of access to healthcare [36]. In addition, small study has evaluated access from the point of view of your social actors [26,37-39], in spite of the limited 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 short article will be to contribute towards the improvement of our understanding of the elements influencing access to the continuum of healthcare services within the Colombian managed competitors model, in the perspective of social actors.Procedures There have been two Regions of Study: one 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. In the former, a wide array of insurers are present, even though inside the latter only one particular subsidized insurance coverage company, with the majority on the contributory insurance enrollees being affiliated in two insurance coverage organizations. In both locations the majority of the population reside in poverty [42]. Within the urban region, the coverage with the subsidized regime is slightly less than inside the rural a.