Access to care [9,10]. Nonetheless, it hasbeen a long, complicated approach, and also the outcomes are controversial [11,12]. In spite in the considerable enhance in public health expenditure from 3 to six.six of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three of your population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of services (POS-S) significantly inferior to that offered by the contributory one particular [16,17]. Around 17 of overall health expenditure is devoted to administrative costs [18], of which more than 50 is spent on supporting each day operations (monetary, personnel, and facts management) and enrollment processes [19]. Additionally, various research seem to indicate a reduce in realized access to solutions [20,21], and point to significant barriers associated 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 solutions, such as geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that may be sensitive towards the general healthcare system, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, though per capita 2004 overall health expenditure had been related (USD 549 and USD 598, respectively) but a GNP per capita reduce in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Solutions Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available evidence points to failures within the condition sine qua non for the profitable implementation of managed competitors, in line with its supporters [1]: the existence of an effective regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their potential to control a great number of institutions related to insufficient monetary sources, lack of control mechanisms and excessive, and sometimes contradictory, regulation norms. Most studies with the determinants of use of care in Colombia focus on personal variables and initial contact with solutions, and ignore contextual variables overall health policy and characteristics of healthcare services. Insurance coverage, measured only by enrolment price, is generally viewed as an independent variable, while in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. Moreover, tiny research has evaluated access in the point of view on the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, as a consequence of methodological troubles in including contextual variables [40,41]. The objective of this short article would be to contribute to the improvement of our understanding of your components influencing access to the continuum of healthcare solutions inside the Colombian managed competitors model, from the point of view of social actors.Solutions There had been two 4-IBP biological activity Places of Study: one 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. In the former, a wide array of insurers are present, although in the latter only a single subsidized insurance coverage company, together with the majority with the contributory insurance coverage enrollees being affiliated in two insurance organizations. In both locations most of the population live in poverty [42]. Within the urban location, the coverage of your subsidized regime is slightly much less than within the rural a.