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Access to care [9,10]. Even so, it hasbeen a extended, complex approach, as well as the results are controversial [11,12]. In spite on the significant increase in public overall health expenditure from three to six.six of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three with the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of solutions (POS-S) greatly inferior to that supplied by the contributory one particular [16,17]. Roughly 17 of overall health expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting each day operations (economic, personnel, and facts management) and enrollment processes [19]. In addition, quite a few research seem to indicate a lower in realized access to services [20,21], and point to substantial barriers related to traits 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, characteristics of services, including geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive towards the all round healthcare system, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, although per capita 2004 health expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita decrease in 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, offered proof points to failures inside the situation sine qua non for the thriving implementation of managed competition, as outlined by its supporters [1]: the existence of an effective regulatory system. These studies [32-35] reveal Ro 67-7476 cost deficiencies in regulation authorities in their potential to control a great variety of institutions related to insufficient monetary resources, lack of control mechanisms and excessive, and from time to time contradictory, regulation norms. Most research of the determinants of use of care in Colombia concentrate on private variables and initial speak to with solutions, and ignore contextual variables overall health policy and qualities of healthcare solutions. Insurance coverage, measured only by enrolment rate, is normally viewed as an independent variable, while in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. In addition, small analysis has evaluated access in the point of view with the social actors [26,37-39], in spite of the limited capacity of quantitative models in explaining determinants of use of care, on account of methodological issues in which includes contextual variables [40,41]. The objective of this short article will be to contribute towards the improvement of our understanding with the factors influencing access towards the continuum of healthcare solutions inside the Colombian managed competition model, from the perspective of social actors.Techniques There were two Locations of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and one particular rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Within the former, a wide array of insurers are present, though inside the latter only one subsidized insurance business, with the majority on the contributory insurance coverage enrollees getting affiliated in two insurance companies. In both places most of the population live in poverty [42]. Within the urban location, the coverage of the subsidized regime is slightly much less than in the rural a.