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Access to care [9,10]. Having said that, it hasbeen a extended, difficult course of action, and also the final results are controversial [11,12]. In spite of your considerable raise in public well being expenditure from 3 to six.six of GDP, over the 1993 to 2007 period [13], about 15.three to 19.3 of your population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of solutions (POS-S) drastically inferior to that offered by the contributory one [16,17]. Roughly 17 of wellness expenditure is devoted to administrative costs [18], of which more than 50 is spent on supporting every day operations (monetary, personnel, and facts management) and enrollment processes [19]. Additionally, many studies appear to indicate a decrease in realized access to solutions [20,21], and point to considerable barriers associated to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, qualities of solutions, for example geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator that’s sensitive for the all round healthcare system, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, when per capita 2004 health expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita reduced inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, out there evidence points to failures in the condition sine qua non for the profitable implementation of managed competitors, according to its supporters [1]: the existence of an effective regulatory system. These research [32-35] order LGH447 reveal deficiencies in regulation authorities in their capacity to control an excellent variety of institutions connected to insufficient financial resources, lack of control mechanisms and excessive, and in some cases contradictory, regulation norms. Most research with the determinants of use of care in Colombia focus on private variables and initial make contact with with solutions, and ignore contextual variables overall health policy and characteristics of healthcare solutions. 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 situations of access to healthcare [36]. Additionally, little investigation has evaluated access in the point of view of 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 difficulties in like contextual variables [40,41]. The objective of this short article is usually to contribute towards the improvement of our understanding of the elements influencing access towards the continuum of healthcare services within the Colombian managed competition model, in the point of view of social actors.Methods There have been two Regions of Study: a single 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. Within the former, a wide array of insurers are present, while in the latter only 1 subsidized insurance firm, together with the majority of your contributory insurance enrollees becoming affiliated in two insurance coverage providers. In each areas the majority of the population live in poverty [42]. In the urban region, the coverage with the subsidized regime is slightly much less than in the rural a.