Access to care [9,10]. On the other hand, it hasbeen a lengthy, complex process, and the outcomes are controversial [11,12]. In spite of the significant improve in public wellness expenditure from three to 6.six of GDP, more than the 1993 to 2007 period [13], around 15.three to 19.three from the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of solutions (POS-S) considerably inferior to that supplied by the contributory one particular [16,17]. Approximately 17 of health expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting day-to-day operations (financial, personnel, and facts management) and enrollment processes [19]. In addition, numerous research seem to indicate a decrease in realized access to solutions [20,21], and point to Nanchangmycin substantial barriers associated to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of services, for example geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality price, an indicator that is definitely sensitive to the general healthcare method, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, though per capita 2004 health expenditure were related (USD 549 and USD 598, respectively) but a GNP per capita lower in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Services Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available proof points to failures inside the condition sine qua non for the productive implementation of managed competitors, based on its supporters [1]: the existence of an effective regulatory program. These research [32-35] reveal deficiencies in regulation authorities in their capability to manage a great number of institutions associated to insufficient economic sources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies of your determinants of use of care in Colombia concentrate on private variables and initial get in touch with with solutions, and ignore contextual variables well being policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment price, is generally viewed as an independent variable, while in managed competitors models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Moreover, tiny investigation has evaluated access in the point of view in the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, as a consequence of methodological issues in which includes contextual variables [40,41]. The objective of this article would be to contribute to the improvement of our understanding on the variables influencing access towards the continuum of healthcare services within the Colombian managed competition model, from the viewpoint of social actors.Solutions There had been two Locations of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and a single 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, though within the latter only one subsidized insurance coverage firm, using the majority with the contributory insurance coverage enrollees becoming affiliated in two insurance coverage providers. In each places most of the population live in poverty [42]. Inside the urban area, the coverage from the subsidized regime is slightly significantly less than in the rural a.