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Access to care [9,10]. However, it hasbeen a extended, complex approach, along with the final results are controversial [11,12]. In spite with the significant improve in public well being expenditure from 3 to 6.6 of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.three of the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of solutions (POS-S) tremendously inferior to that supplied by the contributory one [16,17]. Around 17 of wellness expenditure is devoted to administrative charges [18], of which greater than 50 is spent on supporting everyday operations (economic, personnel, and info management) and enrollment processes [19]. Moreover, various research seem to indicate a lower in realized access to services [20,21], and point to considerable barriers related to traits 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, qualities of solutions, which include geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is definitely sensitive for the overall healthcare system, was 130/100.000 in Colombia, compared to 30/ one hundred.000 in Costa Rica, though per capita 2004 overall health expenditure were similar (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Investigation 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable evidence points to failures inside the situation sine qua non for the prosperous implementation of managed competitors, as outlined by its supporters [1]: the existence of an efficient regulatory program. These research [32-35] reveal Mikamycin IA supplier deficiencies in regulation authorities in their ability to manage a terrific variety of institutions connected to insufficient economic sources, lack of control mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies from the determinants of use of care in Colombia focus on individual variables and initial contact with solutions, and ignore contextual variables wellness policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment price, is typically viewed as an independent variable, though in managed competition models, insurers directly 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 restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological issues in including contextual variables [40,41]. The objective of this short article is always to contribute to the improvement of our understanding from the aspects influencing access to the continuum of healthcare solutions inside the Colombian managed competitors model, from the viewpoint of social actors.Approaches There have been two Places of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and 1 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, even though inside the latter only a single subsidized insurance company, with the majority of the contributory insurance enrollees getting affiliated in two insurance coverage providers. In both regions the majority of the population reside in poverty [42]. In the urban area, the coverage of your subsidized regime is slightly much less than inside the rural a.