Access to care [9,10]. However, it hasbeen a long, complicated method, and also the benefits are controversial [11,12]. In spite from the considerable increase in public well being expenditure from 3 to 6.six of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.three on 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 supplied by the contributory one particular [16,17]. About 17 of overall health expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting everyday operations (monetary, personnel, and information management) and enrollment processes [19]. In addition, various studies look to indicate a lower in realized access to services [20,21], and point to substantial barriers associated to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as XMD8-87 insurance coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, qualities of services, including geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that may be sensitive towards the general healthcare system, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, when per capita 2004 health expenditure were equivalent (USD 549 and USD 598, respectively) but a GNP per capita decrease within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Study 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable evidence points to failures within the situation sine qua non for the prosperous implementation of managed competition, based on its supporters [1]: the existence of an efficient regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to manage an awesome number of institutions related to insufficient financial resources, lack of handle mechanisms and excessive, and from time to time contradictory, regulation norms. Most research on the determinants of use of care in Colombia focus on private variables and initial contact with services, and ignore contextual variables health policy and characteristics of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is usually viewed as an independent variable, although in managed competition models, insurers directly influence the provider networks and conditions of access to healthcare [36]. In addition, small study has evaluated access in the point of view from the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, because of methodological issues in which includes contextual variables [40,41]. The objective of this article is usually to contribute to the improvement of our understanding on the things influencing access towards the continuum of healthcare solutions in the Colombian managed competition model, from the perspective of social actors.Approaches There were two Locations of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and 1 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, whilst within the latter only 1 subsidized insurance coverage company, with the majority on the contributory insurance coverage enrollees being affiliated in two insurance corporations. In each places most of the population live in poverty [42]. In the urban area, the coverage from the subsidized regime is slightly less than in the rural a.