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Access to care [9,10]. Nevertheless, it hasbeen a long, difficult method, along with the final results are controversial [11,12]. In spite on the significant boost in public overall health expenditure from three to 6.six of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.3 of the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a variety of solutions (POS-S) significantly inferior to that provided by the contributory 1 [16,17]. Around 17 of wellness expenditure is devoted to administrative costs [18], of which more than 50 is spent on supporting each day operations (financial, personnel, and details management) and enrollment processes [19]. In addition, a number of research seem to indicate a decrease in realized access to services [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 coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, qualities of solutions, such as geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that may be sensitive towards the all round healthcare program, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, while per capita 2004 well being expenditure have been similar (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 Services Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable proof points to failures in the condition sine qua non for the successful implementation of managed competitors, as outlined by its supporters [1]: the existence of an effective regulatory technique. These studies [32-35] reveal deficiencies in regulation authorities in their ability to manage a great quantity of institutions related to insufficient monetary resources, lack of manage mechanisms and excessive, and often contradictory, regulation norms. Most research from the determinants of use of care in Colombia concentrate on individual variables and initial make contact with with services, and ignore contextual variables overall health policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment rate, is generally viewed as an independent variable, while in managed competitors models, insurers directly influence the provider networks and conditions of access to healthcare [36]. In addition, little research has evaluated access in the point of view of the social actors [26,37-39], despite the restricted capacity of C 87 web quantitative models in explaining determinants of use of care, due to methodological difficulties in such as contextual variables [40,41]. The objective of this article would be to contribute to the improvement of our understanding on the factors influencing access towards the continuum of healthcare solutions in the Colombian managed competition model, from the perspective of social actors.Methods There had been two Places of Study: one 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. Inside the former, a wide array of insurers are present, although within the latter only one particular subsidized insurance corporation, using the majority of your contributory insurance enrollees becoming affiliated in two insurance businesses. In both locations most of the population reside in poverty [42]. Within the urban location, the coverage with the subsidized regime is slightly significantly less than inside the rural a.