Access to care [9,10]. Even so, it hasbeen a lengthy, complex approach, as well as the final results are controversial [11,12]. In spite with the significant boost in public wellness expenditure from three to six.six of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.3 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) drastically inferior to that supplied by the contributory one particular [16,17]. Approximately 17 of wellness expenditure is devoted to administrative fees [18], of which more than 50 is spent on GSK1016790A custom synthesis supporting everyday operations (economic, personnel, and information management) and enrollment processes [19]. Moreover, quite a few studies look to indicate a reduce in realized access to solutions [20,21], and point to important barriers connected to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, qualities of services, which include geographic accessibility and high quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that’s sensitive towards the all round healthcare technique, was 130/100.000 in Colombia, compared to 30/ 100.000 in Costa Rica, although per capita 2004 overall health expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita reduce inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, out there proof points to failures inside the condition sine qua non for the prosperous implementation of managed competitors, in line with its supporters [1]: the existence of an effective regulatory technique. These research [32-35] reveal deficiencies in regulation authorities in their potential to handle an awesome variety of institutions related to insufficient economic resources, lack of control mechanisms and excessive, and sometimes contradictory, regulation norms. Most research from the determinants of use of care in Colombia concentrate 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 rate, is usually viewed as an independent variable, despite the fact that in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare [36]. Moreover, tiny 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, due to methodological issues in including contextual variables [40,41]. The objective of this article is usually to contribute towards the improvement of our understanding with the components influencing access to the continuum of healthcare solutions within the Colombian managed competitors model, in the point of view of social actors.Strategies There have been two Areas of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one particular rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Within the former, a wide array of insurers are present, while in the latter only 1 subsidized insurance organization, with the majority of your contributory insurance enrollees becoming affiliated in two insurance coverage providers. In both locations most of the population live in poverty [42]. Within the urban location, the coverage with the subsidized regime is slightly much less than in the rural a.