Access to care [9,10]. Having said that, it hasbeen a extended, complicated procedure, and the final results are controversial [11,12]. In spite of the substantial enhance in public health expenditure from 3 to six.6 of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.three in the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that K03861 site covers a range of solutions (POS-S) significantly inferior to that provided by the contributory a single [16,17]. Around 17 of wellness expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting every day operations (financial, personnel, and facts management) and enrollment processes [19]. Moreover, many research appear to indicate a reduce in realized access to solutions [20,21], and point to significant barriers associated to qualities 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, such as geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is certainly sensitive towards the general healthcare technique, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, even though per capita 2004 overall health expenditure have been comparable (USD 549 and USD 598, respectively) but a GNP per capita reduced in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Solutions Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available proof points to failures in the situation sine qua non for the productive implementation of managed competition, according to its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their capability to control an incredible variety of institutions connected to insufficient economic sources, lack of manage mechanisms and excessive, and often contradictory, regulation norms. Most research from the determinants of use of care in Colombia focus on individual variables and initial speak to with solutions, and ignore contextual variables overall health policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is often viewed as an independent variable, despite the fact that in managed competitors models, insurers directly influence the provider networks and situations of access to healthcare [36]. Also, little research has evaluated access in the point of view of your social actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, as a consequence of methodological difficulties in such as contextual variables [40,41]. The objective of this short article would be to contribute for the improvement of our understanding in the components influencing access to the continuum of healthcare solutions inside the Colombian managed competitors model, from the point of view of social actors.Techniques There have been two Areas of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Department 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 in the latter only one subsidized insurance enterprise, together with the majority in the contributory insurance enrollees being affiliated in two insurance firms. In each locations most of the population reside in poverty [42]. Inside the urban location, the coverage of the subsidized regime is slightly significantly less than inside the rural a.