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Access to care [9,10]. Even so, it hasbeen a lengthy, difficult approach, along with the final results are controversial [11,12]. In spite of the considerable improve in public health expenditure from three to six.6 of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.3 with the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of solutions (POS-S) greatly inferior to that provided by the contributory 1 [16,17]. About 17 of well being expenditure is devoted to administrative charges [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, many research look to indicate a reduce in realized access to services [20,21], and point to significant barriers associated to characteristics 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 services, like geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is certainly sensitive to the general healthcare system, was 130/100.000 in Colombia, compared to 30/ one hundred.000 in Costa Rica, when per capita 2004 wellness expenditure were similar (USD 549 and USD 598, respectively) but a GNP per capita lower inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, out there proof points to failures inside the condition sine qua non for the successful implementation of managed competitors, based on its supporters [1]: the existence of an efficient regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their ability to handle an excellent number of institutions connected to insufficient financial resources, lack of control mechanisms and excessive, and sometimes contradictory, regulation norms. Most research on the determinants of use of care in Colombia concentrate on individual variables and initial speak to with services, and ignore contextual variables wellness policy and characteristics of healthcare solutions. Insurance coverage coverage, measured only by enrolment rate, is often viewed as an independent variable, although in managed competitors models, insurers directly influence the provider networks and conditions of access to healthcare [36]. Moreover, little analysis has CID-25010775 custom synthesis 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, because of methodological issues in which includes contextual variables [40,41]. The objective of this short article should be to contribute for the improvement of our understanding in the components influencing access to the continuum of healthcare services inside the Colombian managed competitors model, in the perspective of social actors.Strategies There had been two Locations of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one 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, when inside the latter only one particular subsidized insurance business, using the majority from the contributory insurance coverage enrollees getting affiliated in two insurance coverage firms. In both areas the majority of the population live in poverty [42]. In the urban region, the coverage with the subsidized regime is slightly less than within the rural a.