Access to care [9,10]. Even so, it hasbeen a long, complicated process, and the results are controversial [11,12]. In spite of your considerable raise in public well being expenditure from three to six.6 of GDP, over the 1993 to 2007 period [13], around 15.three to 19.3 of the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of services (POS-S) considerably inferior to that supplied by the contributory one [16,17]. Approximately 17 of well being expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting daily operations (economic, personnel, and data management) and enrollment processes [19]. Furthermore, many research seem to indicate a lower in realized access to services [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 enrolment [22-28], income [22,25,26,28], education [22-27,29] and, qualities of services, like geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator that is certainly sensitive for the general healthcare technique, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, even though per capita 2004 wellness expenditure have been similar (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 Overall health Services Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn MedChemExpress ITSA-1 addition, offered evidence points to failures within the condition sine qua non for the productive implementation of managed competition, according to its supporters [1]: the existence of an effective regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their ability to control an excellent quantity of institutions associated to insufficient financial sources, lack of control mechanisms and excessive, and in some cases 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 wellness policy and qualities of healthcare services. Insurance coverage, measured only by enrolment rate, is normally viewed as an independent variable, though in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. In addition, small research has evaluated access from the point of view with the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, because of methodological troubles in which includes contextual variables [40,41]. The objective of this article is always to contribute for the improvement of our understanding with the components influencing access for the continuum of healthcare services within the Colombian managed competitors model, in the point of view of social actors.Strategies There were two Regions of Study: one particular 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. Inside the former, a wide array of insurers are present, while inside the latter only a single subsidized insurance coverage corporation, with all the majority with the contributory insurance enrollees becoming affiliated in two insurance coverage companies. In both locations the majority of the population reside in poverty [42]. Inside the urban region, the coverage of the subsidized regime is slightly much less than in the rural a.