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Access to care [9,10]. Nonetheless, it hasbeen a long, difficult approach, along with the results are controversial [11,12]. In spite on the considerable raise in public health expenditure from three to six.six of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.3 with the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of solutions (POS-S) tremendously inferior to that provided by the contributory a single [16,17]. About 17 of wellness expenditure is devoted to administrative costs [18], of which greater than 50 is spent on supporting everyday operations (economic, personnel, and info management) and enrollment processes [19]. Furthermore, several studies appear to indicate a lower in realized access to services [20,21], and point to significant barriers related to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], income [22,25,26,28], education [22-27,29] and, characteristics of solutions, like geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive for the overall healthcare system, was 130/100.000 in Colombia, compared to 30/ 100.000 in Costa Rica, even though per capita 2004 wellness expenditure have been comparable (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 Health Services Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available proof points to failures in the situation sine qua non for the thriving implementation of managed competition, as TCN238 chemical information outlined by its supporters [1]: the existence of an effective regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their potential to control a terrific quantity of institutions related to insufficient financial sources, lack of control mechanisms and excessive, and at times contradictory, regulation norms. Most studies on the determinants of use of care in Colombia focus on individual variables and initial speak to with services, and ignore contextual variables overall health policy and traits of healthcare services. Insurance coverage, measured only by enrolment rate, is usually viewed as an independent variable, though in managed competition models, insurers straight influence the provider networks and situations of access to healthcare [36]. Additionally, small study 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, on account of methodological difficulties in such as contextual variables [40,41]. The objective of this short article will be to contribute towards the improvement of our understanding from the factors influencing access to the continuum of healthcare services in the Colombian managed competitors model, from the perspective of social actors.Approaches There were two Areas of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one 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, although in the latter only a single subsidized insurance coverage business, with the majority in the contributory insurance enrollees being affiliated in two insurance firms. In both areas the majority of the population reside in poverty [42]. Within the urban region, the coverage of your subsidized regime is slightly much less than inside the rural a.