Access to care [9,10]. Even so, it hasbeen a extended, complicated approach, and the benefits are controversial [11,12]. In spite of your substantial increase in public health expenditure from 3 to 6.6 of GDP, more than the 1993 to 2007 period [13], around 15.three to 19.three with the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of services (POS-S) drastically inferior to that offered by the contributory one particular [16,17]. Approximately 17 of overall health expenditure is devoted to administrative fees [18], of which greater than 50 is spent on supporting daily operations (monetary, personnel, and information and facts management) and enrollment processes [19]. Additionally, many studies appear to indicate a reduce in realized access to services [20,21], and point to considerable barriers related to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, characteristics of services, including geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that’s sensitive for the overall healthcare technique, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, whilst per capita 2004 wellness expenditure were comparable (USD 549 and USD 598, respectively) but a GNP per capita reduced inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, out there proof points to failures within the order BGP-15 condition sine qua non for the productive implementation of managed competition, based on its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their capability to handle a terrific number of institutions associated to insufficient economic sources, lack of handle mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies on the determinants of use of care in Colombia focus on private variables and initial speak to with services, and ignore contextual variables well being policy and qualities of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is often viewed as an independent variable, although in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare [36]. Moreover, tiny investigation has evaluated access from the point of view in the social actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, as a result of methodological issues in which includes contextual variables [40,41]. The objective of this short article will be to contribute towards the improvement of our understanding of the aspects influencing access to the continuum of healthcare solutions within the Colombian managed competitors model, from the viewpoint of social actors.Procedures There have been two Regions of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and one particular 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, when inside the latter only one subsidized insurance coverage company, with all the majority from the contributory insurance coverage enrollees being affiliated in two insurance coverage corporations. In each areas the majority of the population live in poverty [42]. Inside the urban area, the coverage of the subsidized regime is slightly less than in the rural a.